Characterized by a gradual reduction in fetal heart rate (FHR) patterns that is visually detectable, late decelerations warrant a closer look. Safety of selective serotonin reuptake inhibitors in pregnancy. Bistoletti P, Lagercrantz H, Lunell NO. Obstet. doi: 10.1080/02724999208250616, Ledger, W. J., and Blaser, M. J. Sleep-disordered breathing can disturb not only the physiological patterns of maternal sleep, but it could also lead to nocturnal hypoxia, which produces an enhanced activation of the maternal ANS (Pien and Schwab, 2004; Sahin et al., 2008). Moreover, excessive light can impair visual development, thus increasing SNS and HPA axis activation (Weber and Harrison, 2019). doi: 10.1016/s0025-6196(12)62272-1, Benny, P., Al-Akwaa, F. M., Dirkx, C., Schlueter, R. J., Wolfgruber, T. K., Chern, I. Y., et al. Endogenous circadian control of the human autonomic nervous system. Front. doi: 10.1016/j.earlhumdev.2019.01.011, Nordenstam, F., Norman, M., and Wickstrm, R. (2019). Despite the fact that there are contrasting results about the sensitivity of fetal activity reported by the mother (Sorokin et al., 1982; Schmidt et al., 1984), it appears that there is an association between the increase of force and frequency of perceived movements and a reduced risk of stillbirth and negative outcomes (Heazell et al., 2018). As several vital systems are forming around the end of the 2nd trimester (e.g., alveolar ductal development and surfactant secretion begin at 24 WGA), babies born prematurely before 26 WGA have a higher chance of dying or developing neurodevelopmental disability (Moore et al., 2016; Morton and Brodsky, 2016; Hill, 2021c). In this sense, hormones may play a crucial etiological role, as literature shows that gonadal hormones have a significant impact on the sex-dependent differentiation of the entire nervous system (Chung and Auger, 2013). Indeed, dysfunctional CAP can fail in regulating inflammation, thus letting the immune system go unchecked and free to induce tissue damage, shock, and even death, whereas, on the other hand, a functional CAP can prevent microglia activation, thus showing a neuroprotective effect (Garzoni et al., 2013; Frasch et al., 2016). The Developing Human: Clinically Oriented Embryology, 10th Edn. Intervention minimizing preterm infants' exposure to NICU light and noise. Several large jurisdictions with population-wide statistics have shown steady declines, often reaching reductions in the range of 40% per decade. 27, 201209. Biol. To learn what we do to deliver the best health and lifestyle insights to you, check out our content review principles. doi: 10.14814/phy2.13620, Harrison, N. A., Cooper, E., Voon, V., Miles, K., and Critchley, H. D. (2013). Gynecol. Autonomic nervous system dysfunction in the first year of life could have consequences on cardiovascular regulation even during adolescence, which makes paramount monitoring ANS development in the 1st and 2nd year to discover infants at risk. J. Physiol. doi: 10.1016/j.bbi.2013.02.001, Hasain, Z., Mokhtar, N. M., Kamaruddin, N. A., Mohamed Ismail, N. A., Razalli, N. H., Gnanou, J. V., et al. 1983 Jan; 90(1):11-5. 15:650971. doi: 10.3389/fnins.2021.650971, Bordeleau, M., Fernndez de Cosso, L., Chakravarty, M. M., and Tremblay, M.-. Prenatal maternal psychological distress and fetal developmental trajectories: associations with infant temperament. Bone Jt. J. Obstet. Computational experiments finally demonstrate that size attenuation results in the paradoxical . Am. Am J Obstet Gynecol. Rivolta, M. W., Stampalija, T., Casati, D., Richardson, B. S., Ross, M. G., Frasch, M. G., et al. Therefore, temperature that constantly deviates from newborns' one can lead to excessive ANS activation. doi: 10.1126/scitranslmed.3008599, Abdel-Haq, R., Schlachetzki, J. C. M., Glass, C. K., and Mazmanian, S. K. (2018). (2016). Rates of and factors associated with delivery-related perinatal death among term infants in Scotland. 1999 Feb; 93(2):285-91. Embryol. Stages of labor, in StatPearls (Treasure Island, FL: StatPearls Publishing). Fetal movement, in StatPearls (Treasure Island, FL: StatPearls Publishing). 27, 12451250. (2020). Med. With progressive acidemia the decelerations became deeper and longer. Psychosom. Med. Meas. 73, 199213. J. Gynecol. doi: 10.2307/1131844, Doyle, R. M., Harris, K., Kamiza, S., Harjunmaa, U., Ashorn, U., Nkhoma, M., et al. (2003). Hypothermia for newborns with hypoxic-ischemic encephalopathy. (2017). Prenatal stress and its effects on the fetus and the child: possible underlying biological mechanisms, in Perinatal Programming of Neurodevelopment Advances in Neurobiology, ed M. C. Antonelli (New York, NY: Springer New York), 269283. Arch. doi: 10.1371/journal.pone.0022100, Frasch, M. G., Lobmaier, S. M., Stampalija, T., Desplats, P., Pallars, M. E., Pastor, V., et al. An aspect that should not be underestimated in the administration of epidural analgesia is the position of the mother. Doussard-Roosevelt, J. Circulating catecholamines increase heart rate variability.18, Animal experiments have shown that blockage of the parasympathetic system with atropine results in a reduction in short-term variability. (2020b). Res. Dev. doi: 10.1016/B978-0-12-809468-6.00031-0, Prechtl, H. F. (1990). Comput. Invest. Fetal Heart Rate Monitoring. doi: 10.1016/j.neuropharm.2006.03.001, Kamendi, H. W., Cheng, Q., Dergacheva, O., Gorini, C., Jameson, H. S., Wang, X., et al. Goldstein, D. S. (2006). Mapping the immunological homunculus. 2018 Feb 1. Front. The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. Environ. Pregnancy and autoimmune diseases. (2018). (2014). The fetal heart rate response to hypoxia: insights from animal models. The placenta harbors a unique microbiome. (2019). 26:101221. doi: 10.1016/j.siny.2021.101221. doi: 10.1016/j.biopsycho.2010.11.006, Nugent, B. M., and Bale, T. L. (2015). Fetal Diagn. Fetal gut injury due to inflammation in a fetal sheep model of NEC etiology leaves a specific HRV signature and preterm neonates show abnormalities in HRV 13 days before clinical symptoms (Stone et al., 2013; Liu et al., 2016). (2010). Similar hints can also be gained by monitoring organ development due to the research regarding the CAP and the systemic interactions of the vagus nerve (Bonaz et al., 2021). Molecular control of the neural crest and peripheral nervous system development. which intrinsic homeostatic response is the fetus demonstrating . Prenatal influences on temperament development: the role of environmental epigenetics. In summary, the FMs make it possible to start developing a primitive body map. Obstructive sleep apnea in pregnancy and fetal outcome. 30, N1N10. Ethics 46, 36. (2008). In particular, metabolic and cardiovascular pathologies, like obesity, diabetes, hypertension, and preeclampsia, can disrupt vagus nerve development (Brown et al., 2008; Russell et al., 2016; Moors et al., 2020). On the other hand, the hypothalamic-pituitary-adrenals (HPA) axis and vagal activation become more finely tuned (Bystrova, 2009). 1:CD010333. 2003 Mar; 188(3):820-3. Identified Q&As 100+ Solutions available. 2017 Feb;216(2):163.e1-163.e6. Maternal heart rate variability during the first stage of labor. Sleep Med. Rep. 6:e13620. J. Obstet. doi: 10.1097/PCC.0000000000000643, Lobmaier, S. M., Mller, A., Zelgert, C., Shen, C., Su, P. C., Schmidt, G., et al. Med. Gynecol. Gender-specific evolution of fetal heart rate variability throughout gestation: a study of 8823 cases. doi: 10.1152/ajpregu.00120.2012, Hoyer, D., Schmidt, A., Gustafson, K. M., Lobmaier, S. M., Lakhno, I., van Leeuwen, P., et al. Effect of maternal magnesium sulfate treatment on fetal heart rate variability. (2018). Machine Learning refers to a family of software algorithms designed to find the most predictive constellations of factors for a specific outcome by examining actual data. Exposure to SSRIs during the 3rd trimester is associated with blunted FMs and reactivity to VAS, as well as with reduced fHRV at 36 WGA (Oberlander et al., 2009; Nguyen et al., 2019). Natl. 74, 174184. ABP, arterial blood pressure; ANS, autonomic nervous system; ASD, autism spectrum disorders; CAM, cardiac autonomic modulation; CAN, central autonomic network; CAP, cholinergic anti-inflammatory pathway; CNS, central nervous system; CRH, corticotropin-releasing hormone; CS, cesarean section; CTG, cardiotocography; ECG, electrocardiography; EEG, electroencephalography; EFM, electronic fetal monitoring; EMF, electromagnetic field; ENS, enteric nervous system; FASD, fetal alcohol spectrum disorders; fHR, fetal heart rate; fHRV, fetal heart rate variability; FM, fetal movement; GM, general movement; HIE, hypoxic-ischemic encephalopathy; HPA, hypothalamic-pituitary-adrenal; HR, heart rate; HRV, heart rate variability; NAS, neonatal abstinence syndrome; NC, neural crest; NEC, necrotizing enterocolitis; NOWS, neonatal opioid withdrawal syndrome; PAE, prenatal alcohol exposure; PGP, pelvic girdle pain; PNE, prenatal nicotine exposure; PNS, parasympathetic nervous system; REM, rapid eye movements; SDB, sleep-disordered breathing; sGC, synthetic glucocorticoid; SIDS, sudden infant death syndrome; SNS, sympathetic nervous system; sOT, synthetic oxytocin; SSRI, selective serotonin reuptake inhibitor; VAS, vibroacoustic stimulation; WGA, week gestational age; ZIKV, Zika virus. doi: 10.1007/s40572-015-0053-0, Gutke, A., Betten, C., Degerskr, K., Pousette, S., and Olsn, M. F. (2015). Microglia, the missing link in maternal immune activation and fetal neurodevelopment; and a possible link in preeclampsia and disturbed neurodevelopment? Bennet L, Gunn AJ. Porges, S. W. (2011). Ther. Homeostatic circuits usually involve negative feedback loops. The fetal heart, devoid of any sympathetic and parasympathetic influences, showed decelerations suggesting thatintrinsic myocardial depression was the deceleration mechanism in the presence of severe acidosis and hypoxia.12. Dev. doi: 10.1111/j.1749-6632.2012.06445.x, Mercer, B. M., Carr, T. L., Beazley, D. D., Crouse, D. T., and Sibai, B. M. (1999). Oxytocin promotes functional coupling between paraventricular nucleus and both sympathetic and parasympathetic cardioregulatory nuclei. Psychiatry 5:e545. The effect of antenatal steroid treatment on fetal autonomic heart rate regulation revealed by fetal magnetocardiography (fMCG). J. Obstet. Lastly, instrumental malfunctioning can induce life-threatening conditions (Carvajal de la Osa et al., 2020). J. Med. (2021d). Gynecol. 2008 Sep; 112(3):661-6. 27, 223232. (2016). Meas. Pediatrics 137:e20154271. doi: 10.3122/jabfm.2009.02.080057, Venkataraman, R., Kamaluddeen, M., Amin, H., and Lodha, A. Dev. Cell Tissue Res. 107, 475480. 36, 441468. 42, 397412. 301, 405414. These therapies can affect fetal neurodevelopment: the increase prescriptions for opioids during pregnancy, for example, correlates to an increased incidence of neonatal abstinence syndrome (NAS), resulting in sleeping and feeding difficulties, as well as a dysregulation in newborns' CNS (Pryor et al., 2017; Ray-Griffith et al., 2018). Doc Preview. doi: 10.1148/rg.2015150092, Rou, G., Samoilescu, G., Rau, M. C., and Baltag, O. 2:CD006066. 304, R383R392. (2009). Several animal studies in vertebrates and mammals show that vagal NC cells ablation heavily impairs the development and function of the aforementioned tissues. Fetal chemoreception: a developing story. Front. Ther. Bras. Physiology of transition from intrauterine to extrauterine life. Heart rate fall during acute hypoxemia: a measure of chemoreceptor response in fetal sheep. Moreover, considering the role of the vagus nerve in the CAP, which involves immune cells such as macrophages (Borovikova et al., 2000; Tracey, 2007; Fairchild et al., 2010; Frasch et al., 2016), and the sex-related neurodevelopment impact of microglial functions (Hanamsagar and Bilbo, 2016), the different characteristics of the developmental pattern of vagus nerve between male and female fetuses could predispose for sex-specific susceptibility and outcomes in many neurodevelopmental disorders (Berntson and Cacioppo, 2004). Prenatal opioid exposure: neurodevelopmental consequences and future research priorities. Choline: exploring the growing science on its benefits for moms and babies. 37, 668672. doi: 10.1007/s00441-009-0757-2, Schifrin, B. S. (2020). 191, 20412046. Lastly, whereas general movements (GMs) tend to increase until 32 WGA and then decrease as birth approaches, facial movements increase more and more (Borsani et al., 2019). Autonomic responses to sighs in healthy infants and in victims of sudden infant death. Available online at: https://embryology.med.unsw.edu.au/embryology/index.php/Neural_System_Development (accessed April 23, 2021). A. Am J Physiol Heart Circ Physiol. Heart rate variability in healthy term newborns is related to delivery mode: a prospective observational study. Front. A study of fetal heart rate acceleration patterns. Moreover, except the third trimester (Mulkey and du Plessis, 2018, 2019), literature usually lacks an analysis of potential critical windows in the perinatal period that may give information about ANS development. Neuropharmacology 144, 7081. 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).