This is the reason why a measure of vagal modulation like RMSSD could help predict a similar event. Sci. Am. A., Gierczak, M., Pattillo, C., Glynn, L. M., et al. Evidence for adverse effect of perinatal glucocorticoid use on the developing brain. Adrenaline and the Inner World: An Introduction to Scientific Integrative Medicine. https://obgyn.onlinelibrary.wiley.com/doi/pdf/10.1016/j.ijgo.2015.06.020 446, 2233. Frauenh. Inflammatory cytokines in the pathogenesis of periventricular leukomalacia. doi: 10.1038/s41390-021-01460-3, Ray-Griffith, S. L., Wendel, M. P., Stowe, Z. N., and Magann, E. F. (2018). Linear and complex heart rate dynamics vary with sex in relation to fetal behavioural states. (2019). 114, 11941201. In particular, several studies have shown how vagus nerve is involved in many vital processes during fetal, perinatal, and postnatal life: from the regulation of inflammation through the anti-inflammatory cholinergic pathway, which may affect the functioning of each organ, to the production of hormones involved in bioenergetic metabolism. Cell Tissue Res. (2017). Studies in fetal behavior: revisited, renewed, and reimagined. 26:101221. doi: 10.1016/j.siny.2021.101221. During this stage, uterine contractions expose the fetus to continuous and significant hypoxic stress. doi: 10.1111/joa.13230, Kruepunga, N., Hikspoors, J. P. J. M., Hlsman, C. J. M., Mommen, G. M. C., Khler, S. E., and Lamers, W. H. (2021). A Review on the Vagus Nerve and Autonomic Nervous System During Fetal Antibiotic use in pregnancy and drug-resistant infant sepsis. Prenatal maternal psychological distress and fetal developmental trajectories: associations with infant temperament. Front. It has been reported in these cases a correlation with deficit in fetal growth, adverse outcomes for labor and birth, and even preterm birth (Lee and Gay, 2004; Micheli et al., 2011; Zafarghandi et al., 2012; Warland et al., 2018). This detects changes in the normal FHR pattern at the time of labor, reassuring your obstetrician if its safe to proceed. Early Hum. Am. The persistent exposure to photic stimuli or high noise during pregnancy, for instance, due to the mother's occupation, seems to correlate with reduced fetal growth (Selander et al., 2019), increased incidence of congenital heart diseases (Gong et al., 2017), impaired development of cortical areas (Zhang et al., 1992; Wilson et al., 2008), and potential disruption of the vagus nerve maturation. The hypothalamic-pituitary-adrenal axis: development, programming actions of hormones, and maternal-fetal interactions. Autonomic nervous system regulatory capacity begins before birth as the sympathetic and parasympathetic activity contributes significantly to the fetus' development. doi: 10.1016/j.jcrc.2010.11.008, Mulder, E. J. H., Derks, J. Scand. Fetal growth and maternal exposure to particulate matter during pregnancy. doi: 10.1038/pr.2016.155, Bautista, L., and George, R. B. doi: 10.2165/00128072-200002060-00002, Kisilevsky, B. S., and Low, J. (2020). The Dutch Hunger Winter and the developmental origins of health and disease. (2019). Hum. Furthermore, chronic dysfunction of your placenta is sometimes brought on by maternal diseases, like diabetes, collagen-vascular disorders, or hypertension. Pathologic fetal acidemia. Invest. doi: 10.1016/j.clp.2016.04.001, Mowery, N. T., Morris, J. (2013a). Period Med. This seems to be associated with an increased risk for antibiotic-resistant neonatal sepsis (Mercer et al., 1999; Hantoushzadeh et al., 2020). Maternal perfusion in the intervillous space is generally maintained during the early part of a uterine contraction. doi: 10.1016/S1389-9457(03)00107-2, Frasch, M. G. (2018). noradrenaline) biosynthesis and autonomic functions (e.g., temperature, breathing, and satiety regulation) including the area postrema greatly develop around birth (Gokozan et al., 2016). 24, 210213. (2011). Synaptic and intrinsic homeostasis cooperate to optimize single neuron doi: 10.5665/sleep.1616, Yurdakk, K. (2012). 39, 608618. Fetal Heart Rate Physiology and its control with EFM - PeriGen doi: 10.7556/jaoa.2018.108, Snijder, C. A., Roeleveld, N., te Velde, E., Steegers, E. A. P., Raat, H., Hofman, A., et al. 39, 769771. J. There are also repercussions on the fetus, in response to these apneic events: Fetal heart rate decelerations and decreased breathing movements, which could affect neonates' neurobehavior, even if currently there are not enough data to support definitive conclusions about long-term outcomes (Pien and Schwab, 2004). The impact of positioning on bottle-feeding in preterm infants ( 34 GA). Electrical grounding improves vagal tone in preterm infants. Porges, S. W. (2011). doi: 10.1038/sj.jp.7211352, Lauder, A. P., Roche, A. M., Sherrill-Mix, S., Bailey, A., Laughlin, A. L., Bittinger, K., et al. (2013). J. Reprod. Intrapartum-related neonatal encephalopathy incidence and impairment at regional and global levels for 2010 with trends from 1990. General movements allow fetuses to experience their bodies and the surrounding space, hence exploring the consequences their movements have on their bodies and environment (Fagard et al., 2018). Med. Sympathetic neural activation does not mediate heart rate variability during repeated brief umbilical cord occlusions in near-term fetal sheep. A dysregulation in CRH production, secondary to various maternal conditions, such as hypoxia, increased inflammatory cytokines and glucocorticoids, stress, preeclampsia, and eclampsia, may lead to altered neurodevelopmental patterns of these fetal structures (Allen, 2001; Bale, 2016; Sheng et al., 2020). Turk. (2014). Figure 10.7. 1975 Feb;45(2):142-6. Neonatal Individ. The FHR returned to predeceleration levels after the compressions ended in both groups. Hill, M. A. Inadequate maternal nutrition could also lead to excessive weight gain and gestational diabetes, with negative outcomes for the fetus (AlSaif et al., 2015; Edlow, 2017; Peterson et al., 2020; Tong and Kalish, 2020). Am. This effect is believed to benefit the fetus by temporarily reducing myocardial work to compensate for diminished oxygen availability.3-6 A third consequence of chemoreceptor activation of the sympathetic system causes release of other substances such as adrenal catecholamines and vasopressin. Factors that contribute to progressive oxygen debt are strength, duration and frequency of decelerations. Dev. doi: 10.1097/GRF.0b013e31811ebef6, Grandjean, P., Murata, K., Budtz-Jrgensen, E., and Weihe, P. (2004). These situations increase the risk of impairment of fetal brain development resulting in emotional, behavioral, and/or cognitive problems in later life (Glover, 2015; Antonelli et al., 2021). 68, 811824. Moreover, it seems that monitoring FMs could contribute to creating a primitive maternalchild bonding, even before birth (Flenady et al., 2019). The most frequently observed symptoms are: low back pain, headache, pelvic girdle pain (PGP), leg cramps, breast tenderness, abdominal pain, and ligament pain (Davis, 1996; Jarrell, 2017; Lutterodt et al., 2019). Monitoring fetal maturationobjectives, techniques and indices of autonomic function. Figure 4: Decelerations induced by 1 minute hypogastric artery compression with and without acidemia redrawn to scale on fetal monitoring paper grids, adapted from Martin et al. Figure 7: Proposed mechanisms of intrapartum deceleration, adapted from Lear et al. (2016). Moreover, the prolonged administration of MgSO4 seems to be associated with a change in fetal breathing movements (Peaceman et al., 1989) and to affect fHRV dose-dependently (Cardosi and Chez, 1998; Kamitomo et al., 2000). Hull J, Dodd KL. (2020). J. Psychiatry 164, 12061213. Meas. However, we have yet to fully understand ANS development, even after birth. Furthermore, without uterus protection, newborns can be particularly sensitive to sounds, which usually overcome the 45 dB limit recommended by the American Academy of Pediatrics (Almadhoob and Ohlsson, 2020), thus resulting in toxic stress (Weber and Harrison, 2019). J. Neurosci. During pregnancy, the maturation pattern of fetal gonads must be taken into account. (2006). Sampling rate of heart rate variability impacts the ability to detect acidemia in ovine fetuses near-term. Sorokin, Y., Dierker, L. J., Pillay, S. K., Zador, I. E., Schreiner, M. L., and Rosen, M. G. (1982). Coll. Q-Bio. From maternal diet to neurodevelopmental disorders: a story of neuroinflammation. This experiment also demonstrated that adequate time between cord compressions reperfusion time was essential to maintain normal acid base status. doi: 10.4274/tjod.galenos.2019.59932. doi: 10.1016/j.earlhumdev.2015.11.003, Sabir, H., Stannigel, H., Schwarz, A., and Hoehn, T. (2010). The frequency and size of decelerations are important indicators as well as the nature of the FHR between contractions and trends over time. The development of the nociceptive brain. Clinicians shoulder a major and challenging responsibility while caring for mother and baby in labor. From 34th WGA, female fetuses show indeed a higher mean fHR and entropy, as well as a lower short-term variability and sympathovagal balance, compared to the males (Gonalves et al., 2017). This stimulation reaches the brainstem, in particular the nucleus of the solitary tractthe main afferent nucleus of the vagus nervebut also other nuclei including the parabrachial ones, and then more cortical structures such as the hypothalamic paraventricular nucleus and the posterior insular cortex.