Document Detail


The effect of antenatal steroid treatment on fetal autonomic heart rate regulation revealed by fetal magnetocardiography (fMCG).
MedLine Citation:
PMID:  20547444     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Steroid administration to accelerate fetal lung maturation reduces neonatal morbidity and mortality in the case of preterm delivery. Behavioral observations suggest effects on fetal cardiovascular regulation. AIM: We hypothesize that beat to beat heart rate variability (fHRV) derived from fetal magnetocardiography (fMCG) will reveal a direct, acute steroidal effect on fetal autonomic heart rate regulation. SUBJECTS: Eight patients between 29 and 34 weeks of gestation at risk for preterm birth who were treated with betamethasone (2x12 mg within 24 h). STUDY DESIGN: Subjects were studied prior to the first and within 6 h after the second administration. Continuous fMCG was recorded with a 31-channel-SQUID biomagnetometer. Each dataset was processed by subtracting maternal cardiac artefacts and determining the time instants of the fetal heart beats. fHRV analysis was applied to periods of fetal quiescence of 4 min length. OUTCOME MEASURES: We compared fHRV prior versus post steroid administration. RESULTS: Steroid exposure reduced all parameters of overall fHRV significantly. The fHRV parameters representing short term variability remained unaffected. Mean fetal heart rate significantly decreased. The complexity of the heart rate patterns increased. CONCLUSION: Our results suggest an acute shift in the sympatho-vagal balance of fetuses exposed to betamethasone in utero toward sympathetic suppression.
Authors:
Uwe Schneider; Anja Fiedler; Beatrix Schröder; Susann Jaekel; Angelika Stacke; Dirk Hoyer; Ekkehard Schleussner
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Publication Detail:
Type:  Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-06-14
Journal Detail:
Title:  Early human development     Volume:  86     ISSN:  1872-6232     ISO Abbreviation:  Early Hum. Dev.     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-07-08     Completed Date:  2010-09-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7708381     Medline TA:  Early Hum Dev     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  319-25     Citation Subset:  IM    
Copyright Information:
2010 Elsevier Ireland Ltd. All rights reserved.
Affiliation:
Department of Obstetrics, Bachstrasse 18, University Hospital, Jena Germany. Uwe.Schneider@med.uni-jena.de
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MeSH Terms
Descriptor/Qualifier:
Adult
Autonomic Pathways / drug effects
Betamethasone / adverse effects,  pharmacology,  therapeutic use
Female
Fetal Organ Maturity / drug effects
Heart Rate, Fetal / drug effects*
Humans
Magnetocardiography*
Pregnancy
Prenatal Diagnosis / methods
Prenatal Exposure Delayed Effects / chemically induced,  diagnosis*,  physiopathology
Steroids / adverse effects,  pharmacology*,  therapeutic use
Young Adult
Chemical
Reg. No./Substance:
0/Steroids; 378-44-9/Betamethasone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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