title: Ethnic analogies and differences in fetal heart rate variability signal: A retrospective study.
abstract: OBJECTIVE
  We aimed to analyze computerized cardiotocographic (cCTG) parameters (including fetal heart rate baseline, short-term variability, Delta, long-term irregularity [LTI], interval index [II], low frequency [LF], movement frequency [MF], high frequency [HF], and approximate entropy [ApEn]) in physiological term pregnancies in order to correlate them with ethnic differences. The clinical meaning of numerical parameters may explain physiological or paraphysiological phenomena that occur in fetuses of different ethnic origins.
  
  
  METHODS
  A total of 696 pregnant women, including 384 from Europe, 246 from sub-Saharan Africa, 45 from South-East Asia, and 21 from South America, were monitored from the 37th to the 41st week of gestation. Statistical analysis was performed with the analysis of variance test, Pearson correlation test and receiver-operator curves (P < 0.05).
  
  
  RESULTS
  Our results showed statistically significant differences (P < 0.05) between white and black women for Delta, LTI, LF, MF, HF, and ApEn; between white and Asian women for Delta, LTI, MF, and the LF/(HF + MF) ratio; and between white and Latina women for Delta, LTI, and ApEn. In particular, Delta and LTI performed better in the white group than in the black, Asian, and Latina groups. Instead, LF, MF, HF, and ApEn performed better in the black than in the white group.
  
  
  CONCLUSIONS
  Our results confirmed the integrity and normal functionality of both central and autonomic nervous system components for all fetuses investigated. Therefore, CTG monitoring should include both linear and nonlinear components of fetal heart rate variability in order to avoid misinterpretations of the CTG trace among ethnic groups.
authors.affiliation: Department of Obstetrical-Gynaecological and Urological Science and Reproductive Medicine, Federico II University, Naples.
authors.forename: Salvatore
authors.identifier: http://orcid.org/0000-0002-8699-6544
authors.initials: S
authors.lastname: Tagliaferri
authors.affiliation: Department of Obstetrical-Gynaecological and Urological Science and Reproductive Medicine, Federico II University, Naples.
authors.forename: Francesca Giovanna
authors.initials: FG
authors.lastname: Esposito
authors.affiliation: Department of Obstetrical-Gynaecological and Urological Science and Reproductive Medicine, Federico II University, Naples.
authors.forename: Rosa
authors.initials: R
authors.lastname: Fagioli
authors.affiliation: Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia.
authors.forename: Marco
authors.initials: M
authors.lastname: Di Cresce
authors.affiliation: Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia.
authors.forename: Lucia
authors.initials: L
authors.lastname: Sacchi
authors.affiliation: Department of Electronics, Information and Bioengineering, Polytechnic of Milan, Milan, Italy.
authors.forename: Maria Gabriella
authors.initials: MG
authors.lastname: Signorini
authors.affiliation: Department of Obstetrical-Gynaecological and Urological Science and Reproductive Medicine, Federico II University, Naples.
authors.forename: Marta
authors.initials: M
authors.lastname: Campanile
authors.affiliation: Department of Obstetrical-Gynaecological and Urological Science and Reproductive Medicine, Federico II University, Naples.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Martinelli
authors.affiliation: Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Magenes
mesh_terms: D000328:Adult; D000349:Africa / Q000208:ethnology; D000569:Americas / Q000208:ethnology; D001208:Asia / Q000208:ethnology; D015148:Cardiotocography / Q000379:methods*; D005260:Female; D006340:Heart Rate, Fetal / Q000502:physiology*; D006801:Humans; D011247:Pregnancy; D012189:Retrospective Studies; D055815:Young Adult
keywords: African continental ancestry group; Asian continental ancestry group; computer-assisted; fetal monitoring; signal interpretation; spectrum analysis