Influence of paced maternal breathing on fetal-maternal heart rate coordination

Abstract

Pregnant mothers often report a special awareness of and bonding with their unborn child. Little is known about this relationship although it may offer potential for the assessment of the fetal condition. Recently we found evidence of short epochs of fetal-maternal heart rate synchronization under uncontrolled conditions with spontaneous maternal breathing. Here, we examine whether the occurrence of such epochs can be influenced by maternal respiratory arrhythmia induced by paced breathing at several different rates (10, 12, 15, and 20 cycles per minute). To test for such weak and nonstationary synchronizations among the fetal-maternal subsystems, we apply a multivariate synchronization analysis technique and test statistics based on twin surrogates. We find a clear increase in synchronization epochs mostly at high maternal respiratory rates in the original but not in the surrogate data. On the other hand, fewer epochs are found at low respiratory rates both in original and surrogate data. The results suggest that the fetal cardiac system seems to possess the capability to adjust its rate of activation in response to external--i.e., maternal--stimulation. Hence, the pregnant mothers' special awareness to the unborn child may also be reflected by fetal-maternal interaction of cardiac activity. Our approach opens up the chance to examine this interaction between independent but closely linked physiological systems.

Fig. 1.

Box plots showing the number of SE at different respiratory rates in the original (A) and surrogate (B) data. Note that at 20 cpm in the original data (A), five of the six subjects have 7 SE and one had 9 SE and therefore the interquartile box consists of a line at the value 7. Also, as there were 20 surrogate datasets for each original, the number of SE found in the surrogate data for each respiratory condition was divided by 20 for comparability. (pre, post: datasets of spontaneous breathing before and after controlled breathing.)

Fig. 2.

Distribution of the SE over the maternal beat phases in the original and surrogate data with respect to the n:m combinations 3:2, 4:3, and 5:3 in the different respiratory conditions. For the original data, the number of SE found is given at the top left of each graph. As there were 20 surrogate datasets for each original, the number of SE found in the surrogate data were divided by 20 for comparability. The arrows indicate clear phase preferences. P values are given for histograms containing at least 6 SE. (pre, post: datasets of spontaneous breathing before and following controlled breathing.)