title: Fetal heart rate and motor development in overweight and obese pregnant women.
abstract: OBJECTIVE
  To determine the relationship between maternal prepregnancy body mass index (BMI) and fetal cardiac and motor activity and integration during the second half of pregnancy.
  
  
  METHODS
  Longitudinal data were collected from 610 nonsmoking women with normally progressing pregnancies at three gestational periods (24, 30-32, and 36 weeks) across eight cohorts studied between 1997 and 2013. Fifty minutes of fetal heart rate and motor activity data were collected at each period via actocardiography in a laboratory setting. Data were digitized and analyzed using customized software. Standard BMI categories were computed from maternal prepregnancy weight and height. Participants were stratified into normal weight (n=401, 65.7%), overweight (n=137, 22.5%), or obese (n=72, 11.8%).
  
  
  RESULTS
  Fetuses of obese women showed lower heart rate variability and fewer accelerations relative to fetuses of normal weight women. Fetuses of both obese and overweight women exhibited more vigorous motor activity than fetuses of normal weight women. Cardiac-somatic integration was reduced in both obese and overweight groups. Findings differed by gestational age at assessment.
  
  
  CONCLUSIONS
  Excess maternal prepregnancy weight in overweight and obese women alters the normal trajectory of fetal cardiac and motor development and their integration, with effects amplified as pregnancy progresses.
authors.affiliation: Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Kristin M
authors.initials: KM
authors.lastname: Voegtline
authors.affiliation: Department of Gynecology and Obstetrics, Division of Maternal-Fetal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Kathleen A
authors.initials: KA
authors.lastname: Costigan
authors.affiliation: Department of Gynecology and Obstetrics, Division of Maternal-Fetal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Janice L
authors.initials: JL
authors.lastname: Henderson
authors.affiliation: Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. Electronic address: jdipiet1@jhu.edu.
authors.forename: Janet A
authors.initials: JA
authors.lastname: DiPietro
mesh_terms: D000328:Adult; D015992:Body Mass Index; D001835:Body Weight; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D005865:Gestational Age; D006340:Heart Rate, Fetal / Q000502:physiology*; D006801:Humans; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008297:Male; D009765:Obesity / Q000150:complications*; D050177:Overweight / Q000150:complications*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011256:Pregnancy Outcome; D011446:Prospective Studies
keywords: Fetal heart rate; Fetal motor activity; Maternal overweight; Obesity and pregnancy; Prepregnancy body mass index