2024 Fiscal Year Final Research Report
Nonlinear analyses of heart rate variability obtained from maternal abdominal-lead fetal ECG
| Project/Area Number |
19K09830
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Review Section |
Basic Section 56040:Obstetrics and gynecology-related
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| Research Institution | Saitama Medical University |
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Principal Investigator |
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| Co-Investigator(Kenkyū-buntansha) |
金杉 知宣 岩手医科大学, 医学部, 非常勤医師 (40453302)
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| Project Period (FY) |
2019-04-01 – 2025-03-31
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| Keywords | 母体腹壁誘導胎児心電図 / 胎児心拍数基線細変動 / 胎児発育不全(FGR) / カオス時系列解析 / アトラクタ再構成 / 最大リアプノフ指数 / 相関次元 / サロゲート データ法 |
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| Outline of Final Research Achievements |
The aim of this study was to clarify the difference in dynamics of heart rate variability between normal and growth-restricted fetuses by nonlinear methods of time series analysis using fetal electrocardiogram (ECG) through the maternal abdominal wall. Forty-nine fetal heart rate recordings from healthy normal fetuses and twenty-five recordings from growth-restricted fetuses were analyzed by ECG and conventional ultrasound Doppler methods. The largest Lyapunov exponents were positive in both fetuses by the two methods, and specific nonlinearity was also observed with surrogate data method. The correlation dimension in the control fetuses were significantly higher than those in the growth-restricted fetuses by both methods. According to gestational age, the correlation dimension showed an increase in the control fetuses by both techniques, whereas this significant variation in growth-restricted fetuses could be detected only by ECG.
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| Free Research Field |
周産期医学
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| Academic Significance and Societal Importance of the Research Achievements |
母体腹壁誘導胎児心電図から得られた胎児心拍数変動に対してカオス時系列解析を行い、健常胎児と発育不全胎児における心拍数変動ダイナミクスに差異があることが明らかになった。胎児の健常性を予測する上で最重要とされる胎児心拍数基線細変動(variability)の検出限界は既存の超音波ドプラ法では5bpmであり胎児機能不全を予測する点で偽陽性が多く分娩への不要な手術的介入を増加させる一因にもなっていた。心電図法での検出限界は1bpm以下であり、初期値鋭敏性を有するカオス時系列解析をもちいれば、種々の状態の胎児健常性の評価ひいては治療判断の大幅な向上に寄与すると考えられる。
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