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Amy J Elliott - One of the best experts on this subject based on the ideXlab platform.
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concurrent prenatal drinking and smoking increases risk for sids Safe Passage study report
EClinicalMedicine, 2020Co-Authors: Jyoti Angal, Amy J Elliott, William P Fifer, Robin L Haynes, Colleen A Wright, Hannah C Kinney, Johan D Dempers, Theonia K BoydAbstract:Abstract Background Sudden infant death syndrome (SIDS) is the leading cause of postneonatal mortality. Although the rate has plateaued, any unexpected death of an infant is a family tragedy thus finding causes and contributors to risk remains a major public health concern. The primary objective of this investigation was to determine patterns of drinking and smoking during pregnancy that increase risk of SIDS. Methods The Safe Passage Study was a prospective, multi-center, observational study with 10,088 women, 11,892 pregnancies, and 12,029 fetuses, followed to 1-year post delivery. Subjects were from two sites in Cape Town, South Africa and five United States sites, including two American Indian Reservations. Group-based trajectory modeling was utilized to categorize patterns of drinking and smoking exposure during pregnancy. Findings One-year outcome was ascertained in 94·2% infants, with 28 SIDS (2·43/1000) and 38 known causes of death (3·30/1000). The increase in relative risk for SIDS, adjusted for key demographic and clinical characteristics, was 11·79 (98·3% CI: 2·59–53·7, p Interpretation Infants prenatally exposed to both alcohol and cigarettes continuing beyond the first trimester have a substantially higher risk for SIDS compared to those unexposed, exposed to alcohol or cigarettes alone, or when mother reported quitting early in pregnancy. Given that prenatal drinking and smoking are modifiable risk factors, these results address a major global public health problem. Funding National Institute on Alcohol Abuse and Alcoholism , Eunice Kennedy Shriver National Institute of Child Health and Human Development, and the National Institute on Deafness and Other Communication Disorders.
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Fetal heart rate, heart rate variability, and heart rate/movement coupling in the Safe Passage Study
Journal of Perinatology, 2019Co-Authors: Lauren C. Shuffrey, Hein J. Odendaal, Carlie Plessis, Coen Groenewald, Larry Burd, Jyoti Angal, J. David Nugent, Amy J Elliott, Michael M Myers, Joseph R. IslerAbstract:Objective To determine normative values for heart rate patterns in healthy fetuses. Methods This research is from the Safe Passage Study conducted by the Prenatal Alcohol and SIDS and Stillbirth (PASS) Network. A standardized protocol assessed fetal heart rate (FHR), heart rate variability (HRV), and movement from 1655 fetuses at three-time points during gestation (20–24 weeks, 28–32 weeks, 34–38 weeks gestation). Results FHR decreased while HRV increased over gestation. At the latter two ages, males had significantly lower FHR than females while there were no sex differences in FHR at 20–24 weeks. When accounting for the fetal state during late gestation (34–28 weeks), we found that males had significantly lower FHR than females in the active fetal state only. Conclusion Results demonstrate significant state, gestational age, and sex-related changes in cardiac activity, somatic activity, and autonomic function as the fetus approaches birth.
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Fetal heart rate, heart rate variability, and heart rate/movement coupling in the Safe Passage Study.
Journal of Perinatology, 2019Co-Authors: Lauren C. Shuffrey, Hein J. Odendaal, Coen Groenewald, Larry Burd, Jyoti Angal, Du Plessis C, Nugent Jd, Amy J Elliott, Michael M Myers, IslerAbstract:To determine normative values for heart rate patterns in healthy fetuses. This research is from the Safe Passage Study conducted by the Prenatal Alcohol and SIDS and Stillbirth (PASS) Network. A standardized protocol assessed fetal heart rate (FHR), heart rate variability (HRV), and movement from 1655 fetuses at three-time points during gestation (20–24 weeks, 28–32 weeks, 34–38 weeks gestation). FHR decreased while HRV increased over gestation. At the latter two ages, males had significantly lower FHR than females while there were no sex differences in FHR at 20–24 weeks. When accounting for the fetal state during late gestation (34–28 weeks), we found that males had significantly lower FHR than females in the active fetal state only. Results demonstrate significant state, gestational age, and sex-related changes in cardiac activity, somatic activity, and autonomic function as the fetus approaches birth.
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fetal heart rate heart rate variability and heart rate movement coupling in the Safe Passage study
Journal of Perinatology, 2019Co-Authors: Lauren C. Shuffrey, Hein J. Odendaal, Carlie Plessis, Coen Groenewald, Larry Burd, Jyoti Angal, Amy J Elliott, Michael M Myers, David J. Nugent, Joseph R. IslerAbstract:To determine normative values for heart rate patterns in healthy fetuses. This research is from the Safe Passage Study conducted by the Prenatal Alcohol and SIDS and Stillbirth (PASS) Network. A standardized protocol assessed fetal heart rate (FHR), heart rate variability (HRV), and movement from 1655 fetuses at three-time points during gestation (20–24 weeks, 28–32 weeks, 34–38 weeks gestation). FHR decreased while HRV increased over gestation. At the latter two ages, males had significantly lower FHR than females while there were no sex differences in FHR at 20–24 weeks. When accounting for the fetal state during late gestation (34–28 weeks), we found that males had significantly lower FHR than females in the active fetal state only. Results demonstrate significant state, gestational age, and sex-related changes in cardiac activity, somatic activity, and autonomic function as the fetus approaches birth.
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cardiorespiratory physiology in the Safe Passage study protocol methods and normative values in unexposed infants
Acta Paediatrica, 2017Co-Authors: Michael M Myers, Hein J. Odendaal, Coen Groenewald, Larry Burd, Jyoti Angal, Joseph R. Isler, Amy J Elliott, James David Nugent, Joel S C Yang, Kim A DukesAbstract:AIM: The Safe Passage Study, conducted by the Prenatal Alcohol in SIDS and Stillbirth Network, is investigating contributions of prenatal alcohol exposure to foetal and infant demise. This current report presents physiological data from full-term infants with no prenatal exposure to alcohol or maternal smoking. METHODS: Data are from 666 infants from the Northern Plains (North and South Dakota) and South Africa. A standardised protocol assessed cardiorespiratory function during baseline and head-up tilts shortly after birth and at one month of age. RESULTS: Analyses revealed significant increases in heart rate and decreases in BP from the newborn to one-month time period as well as diminished heart rate responses to head-up tilt in one-month-old infants. CONCLUSION: The Safe Passage Study was successful in characterising physiology in a large number of infants at sites known to have elevated risks for SIDS. Results demonstrate that even with low prenatal adverse exposures, there are significant changes in cardiorespiratory function as infants enter the window of increased risk for SIDS.
Joseph R. Isler - One of the best experts on this subject based on the ideXlab platform.
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association between prenatal exposure to alcohol and tobacco and neonatal brain activity results from the Safe Passage study
JAMA network open, 2020Co-Authors: Lauren C. Shuffrey, Joseph R. Isler, Michael M Myers, Nicolò Pini, Maristella Lucchini, Ayesha Sania, David J. Nugent, Carmen Condon, Timothy Ochoa, Lucy BrinkAbstract:Importance Research to date has not determined a Safe level of alcohol or tobacco use during pregnancy. Electroencephalography (EEG) is a noninvasive measure of cortical function that has previously been used to examine effects of in utero exposures and associations with neurodevelopment. Objective To examine the association of prenatal exposure to alcohol (PAE) and tobacco smoking (PTE) with brain activity in newborns. Design, Setting, and Participants This prospective cohort study enrolled mother-newborn dyads from December 2011 through August 2015, with data analyzed from June 2018 through June 2019. Pregnant women were recruited from clinical sites in Cape Town, South Africa, and the Northern Plains region of the US. Participants were a subset of newborns enrolled in the Safe Passage Study. Exclusions included birth at less than 37 or more than 41 weeks’ gestation, multiple birth, or maternal use of psychiatric medication during pregnancy. Exposures PAE and PTE groups were determined by cluster analysis. Main Outcomes and Measures Analyses of covariance were run on EEG spectral power at 12 scalp locations across the frequency spectrum from 1 to 45 Hz in 3-Hz bins by sleep state. Results The final sample consisted of 1739 newborns (median [interquartile range] gestational age at birth, 39.29 [1.57] weeks; 886 [50.9%] were female; median [interquartile range] newborn age at assessment, 48.53 [44.96] hours). Newborns whose mothers were in the low continuous (95% CI, −0.379 to −0.031;P Conclusions and Relevance These findings suggest that even low levels of PAE or PTE are associated with changes in offspring brain development.
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Fetal heart rate, heart rate variability, and heart rate/movement coupling in the Safe Passage Study
Journal of Perinatology, 2019Co-Authors: Lauren C. Shuffrey, Hein J. Odendaal, Carlie Plessis, Coen Groenewald, Larry Burd, Jyoti Angal, J. David Nugent, Amy J Elliott, Michael M Myers, Joseph R. IslerAbstract:Objective To determine normative values for heart rate patterns in healthy fetuses. Methods This research is from the Safe Passage Study conducted by the Prenatal Alcohol and SIDS and Stillbirth (PASS) Network. A standardized protocol assessed fetal heart rate (FHR), heart rate variability (HRV), and movement from 1655 fetuses at three-time points during gestation (20–24 weeks, 28–32 weeks, 34–38 weeks gestation). Results FHR decreased while HRV increased over gestation. At the latter two ages, males had significantly lower FHR than females while there were no sex differences in FHR at 20–24 weeks. When accounting for the fetal state during late gestation (34–28 weeks), we found that males had significantly lower FHR than females in the active fetal state only. Conclusion Results demonstrate significant state, gestational age, and sex-related changes in cardiac activity, somatic activity, and autonomic function as the fetus approaches birth.
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fetal heart rate heart rate variability and heart rate movement coupling in the Safe Passage study
Journal of Perinatology, 2019Co-Authors: Lauren C. Shuffrey, Hein J. Odendaal, Carlie Plessis, Coen Groenewald, Larry Burd, Jyoti Angal, Amy J Elliott, Michael M Myers, David J. Nugent, Joseph R. IslerAbstract:To determine normative values for heart rate patterns in healthy fetuses. This research is from the Safe Passage Study conducted by the Prenatal Alcohol and SIDS and Stillbirth (PASS) Network. A standardized protocol assessed fetal heart rate (FHR), heart rate variability (HRV), and movement from 1655 fetuses at three-time points during gestation (20–24 weeks, 28–32 weeks, 34–38 weeks gestation). FHR decreased while HRV increased over gestation. At the latter two ages, males had significantly lower FHR than females while there were no sex differences in FHR at 20–24 weeks. When accounting for the fetal state during late gestation (34–28 weeks), we found that males had significantly lower FHR than females in the active fetal state only. Results demonstrate significant state, gestational age, and sex-related changes in cardiac activity, somatic activity, and autonomic function as the fetus approaches birth.
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cardiorespiratory physiology in the Safe Passage study protocol methods and normative values in unexposed infants
Acta Paediatrica, 2017Co-Authors: Michael M Myers, Hein J. Odendaal, Coen Groenewald, Larry Burd, Jyoti Angal, Joseph R. Isler, Amy J Elliott, James David Nugent, Joel S C Yang, Kim A DukesAbstract:AIM: The Safe Passage Study, conducted by the Prenatal Alcohol in SIDS and Stillbirth Network, is investigating contributions of prenatal alcohol exposure to foetal and infant demise. This current report presents physiological data from full-term infants with no prenatal exposure to alcohol or maternal smoking. METHODS: Data are from 666 infants from the Northern Plains (North and South Dakota) and South Africa. A standardised protocol assessed cardiorespiratory function during baseline and head-up tilts shortly after birth and at one month of age. RESULTS: Analyses revealed significant increases in heart rate and decreases in BP from the newborn to one-month time period as well as diminished heart rate responses to head-up tilt in one-month-old infants. CONCLUSION: The Safe Passage Study was successful in characterising physiology in a large number of infants at sites known to have elevated risks for SIDS. Results demonstrate that even with low prenatal adverse exposures, there are significant changes in cardiorespiratory function as infants enter the window of increased risk for SIDS.
Hein J. Odendaal - One of the best experts on this subject based on the ideXlab platform.
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Cluster Analysis of Alcohol Consumption during Pregnancy in the Safe Passage Study
2019 41st Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC), 2019Co-Authors: Nicolò Pini, Lauren C. Shuffrey, Hein J. Odendaal, William P Fifer, Maristella Lucchini, Ayesha Sania, Morgan E. Nelson, David J. Nugent, Timothy N. Ochoa, Michael M MyersAbstract:Characterization of patterns of alcohol consumption during pregnancy encompasses multiple factors such as magnitude, frequency, and timing of exposure throughout gestation. Traditional statistical models are limited in dealing with multivariate and diverse patterns of exposure as in the context of this analysis. We propose a finite mixture model-based approach to derive clusters of alcohol exposure of participants in the Safe Passage Study (PASS). Daily alcohol consumption data for 11,083 pregnant women have been clustered in 10 different exposed groups. The resulting cluster analysis was able to characterize alcohol consumption in a comprehensive framework capable of taking into account both quantity and timing of exposure as well as the occurrence of binge drinking.
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EMBC - Cluster Analysis of Alcohol Consumption during Pregnancy in the Safe Passage Study
Conference proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and, 2019Co-Authors: Nicolò Pini, Lauren C. Shuffrey, Hein J. Odendaal, J. David Nugent, William P Fifer, Maristella Lucchini, Ayesha Sania, Morgan E. Nelson, Timothy N. Ochoa, Michael M MyersAbstract:Characterization of patterns of alcohol consumption during pregnancy encompasses multiple factors such as magnitude, frequency, and timing of exposure throughout gestation. Traditional statistical models are limited in dealing with multivariate and diverse patterns of exposure as in the context of this analysis. We propose a finite mixture model-based approach to derive clusters of alcohol exposure of participants in the Safe Passage Study (PASS). Daily alcohol consumption data for 11,083 pregnant women have been clustered in 10 different exposed groups. The resulting cluster analysis was able to characterize alcohol consumption in a comprehensive framework capable of taking into account both quantity and timing of exposure as well as the occurrence of binge drinking.
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Fetal heart rate, heart rate variability, and heart rate/movement coupling in the Safe Passage Study
Journal of Perinatology, 2019Co-Authors: Lauren C. Shuffrey, Hein J. Odendaal, Carlie Plessis, Coen Groenewald, Larry Burd, Jyoti Angal, J. David Nugent, Amy J Elliott, Michael M Myers, Joseph R. IslerAbstract:Objective To determine normative values for heart rate patterns in healthy fetuses. Methods This research is from the Safe Passage Study conducted by the Prenatal Alcohol and SIDS and Stillbirth (PASS) Network. A standardized protocol assessed fetal heart rate (FHR), heart rate variability (HRV), and movement from 1655 fetuses at three-time points during gestation (20–24 weeks, 28–32 weeks, 34–38 weeks gestation). Results FHR decreased while HRV increased over gestation. At the latter two ages, males had significantly lower FHR than females while there were no sex differences in FHR at 20–24 weeks. When accounting for the fetal state during late gestation (34–28 weeks), we found that males had significantly lower FHR than females in the active fetal state only. Conclusion Results demonstrate significant state, gestational age, and sex-related changes in cardiac activity, somatic activity, and autonomic function as the fetus approaches birth.
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Fetal heart rate, heart rate variability, and heart rate/movement coupling in the Safe Passage Study.
Journal of Perinatology, 2019Co-Authors: Lauren C. Shuffrey, Hein J. Odendaal, Coen Groenewald, Larry Burd, Jyoti Angal, Du Plessis C, Nugent Jd, Amy J Elliott, Michael M Myers, IslerAbstract:To determine normative values for heart rate patterns in healthy fetuses. This research is from the Safe Passage Study conducted by the Prenatal Alcohol and SIDS and Stillbirth (PASS) Network. A standardized protocol assessed fetal heart rate (FHR), heart rate variability (HRV), and movement from 1655 fetuses at three-time points during gestation (20–24 weeks, 28–32 weeks, 34–38 weeks gestation). FHR decreased while HRV increased over gestation. At the latter two ages, males had significantly lower FHR than females while there were no sex differences in FHR at 20–24 weeks. When accounting for the fetal state during late gestation (34–28 weeks), we found that males had significantly lower FHR than females in the active fetal state only. Results demonstrate significant state, gestational age, and sex-related changes in cardiac activity, somatic activity, and autonomic function as the fetus approaches birth.
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fetal heart rate heart rate variability and heart rate movement coupling in the Safe Passage study
Journal of Perinatology, 2019Co-Authors: Lauren C. Shuffrey, Hein J. Odendaal, Carlie Plessis, Coen Groenewald, Larry Burd, Jyoti Angal, Amy J Elliott, Michael M Myers, David J. Nugent, Joseph R. IslerAbstract:To determine normative values for heart rate patterns in healthy fetuses. This research is from the Safe Passage Study conducted by the Prenatal Alcohol and SIDS and Stillbirth (PASS) Network. A standardized protocol assessed fetal heart rate (FHR), heart rate variability (HRV), and movement from 1655 fetuses at three-time points during gestation (20–24 weeks, 28–32 weeks, 34–38 weeks gestation). FHR decreased while HRV increased over gestation. At the latter two ages, males had significantly lower FHR than females while there were no sex differences in FHR at 20–24 weeks. When accounting for the fetal state during late gestation (34–28 weeks), we found that males had significantly lower FHR than females in the active fetal state only. Results demonstrate significant state, gestational age, and sex-related changes in cardiac activity, somatic activity, and autonomic function as the fetus approaches birth.
Lauren C. Shuffrey - One of the best experts on this subject based on the ideXlab platform.
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association between prenatal exposure to alcohol and tobacco and neonatal brain activity results from the Safe Passage study
JAMA network open, 2020Co-Authors: Lauren C. Shuffrey, Joseph R. Isler, Michael M Myers, Nicolò Pini, Maristella Lucchini, Ayesha Sania, David J. Nugent, Carmen Condon, Timothy Ochoa, Lucy BrinkAbstract:Importance Research to date has not determined a Safe level of alcohol or tobacco use during pregnancy. Electroencephalography (EEG) is a noninvasive measure of cortical function that has previously been used to examine effects of in utero exposures and associations with neurodevelopment. Objective To examine the association of prenatal exposure to alcohol (PAE) and tobacco smoking (PTE) with brain activity in newborns. Design, Setting, and Participants This prospective cohort study enrolled mother-newborn dyads from December 2011 through August 2015, with data analyzed from June 2018 through June 2019. Pregnant women were recruited from clinical sites in Cape Town, South Africa, and the Northern Plains region of the US. Participants were a subset of newborns enrolled in the Safe Passage Study. Exclusions included birth at less than 37 or more than 41 weeks’ gestation, multiple birth, or maternal use of psychiatric medication during pregnancy. Exposures PAE and PTE groups were determined by cluster analysis. Main Outcomes and Measures Analyses of covariance were run on EEG spectral power at 12 scalp locations across the frequency spectrum from 1 to 45 Hz in 3-Hz bins by sleep state. Results The final sample consisted of 1739 newborns (median [interquartile range] gestational age at birth, 39.29 [1.57] weeks; 886 [50.9%] were female; median [interquartile range] newborn age at assessment, 48.53 [44.96] hours). Newborns whose mothers were in the low continuous (95% CI, −0.379 to −0.031;P Conclusions and Relevance These findings suggest that even low levels of PAE or PTE are associated with changes in offspring brain development.
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Cluster Analysis of Alcohol Consumption during Pregnancy in the Safe Passage Study
2019 41st Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC), 2019Co-Authors: Nicolò Pini, Lauren C. Shuffrey, Hein J. Odendaal, William P Fifer, Maristella Lucchini, Ayesha Sania, Morgan E. Nelson, David J. Nugent, Timothy N. Ochoa, Michael M MyersAbstract:Characterization of patterns of alcohol consumption during pregnancy encompasses multiple factors such as magnitude, frequency, and timing of exposure throughout gestation. Traditional statistical models are limited in dealing with multivariate and diverse patterns of exposure as in the context of this analysis. We propose a finite mixture model-based approach to derive clusters of alcohol exposure of participants in the Safe Passage Study (PASS). Daily alcohol consumption data for 11,083 pregnant women have been clustered in 10 different exposed groups. The resulting cluster analysis was able to characterize alcohol consumption in a comprehensive framework capable of taking into account both quantity and timing of exposure as well as the occurrence of binge drinking.
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EMBC - Cluster Analysis of Alcohol Consumption during Pregnancy in the Safe Passage Study
Conference proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and, 2019Co-Authors: Nicolò Pini, Lauren C. Shuffrey, Hein J. Odendaal, J. David Nugent, William P Fifer, Maristella Lucchini, Ayesha Sania, Morgan E. Nelson, Timothy N. Ochoa, Michael M MyersAbstract:Characterization of patterns of alcohol consumption during pregnancy encompasses multiple factors such as magnitude, frequency, and timing of exposure throughout gestation. Traditional statistical models are limited in dealing with multivariate and diverse patterns of exposure as in the context of this analysis. We propose a finite mixture model-based approach to derive clusters of alcohol exposure of participants in the Safe Passage Study (PASS). Daily alcohol consumption data for 11,083 pregnant women have been clustered in 10 different exposed groups. The resulting cluster analysis was able to characterize alcohol consumption in a comprehensive framework capable of taking into account both quantity and timing of exposure as well as the occurrence of binge drinking.
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Fetal heart rate, heart rate variability, and heart rate/movement coupling in the Safe Passage Study
Journal of Perinatology, 2019Co-Authors: Lauren C. Shuffrey, Hein J. Odendaal, Carlie Plessis, Coen Groenewald, Larry Burd, Jyoti Angal, J. David Nugent, Amy J Elliott, Michael M Myers, Joseph R. IslerAbstract:Objective To determine normative values for heart rate patterns in healthy fetuses. Methods This research is from the Safe Passage Study conducted by the Prenatal Alcohol and SIDS and Stillbirth (PASS) Network. A standardized protocol assessed fetal heart rate (FHR), heart rate variability (HRV), and movement from 1655 fetuses at three-time points during gestation (20–24 weeks, 28–32 weeks, 34–38 weeks gestation). Results FHR decreased while HRV increased over gestation. At the latter two ages, males had significantly lower FHR than females while there were no sex differences in FHR at 20–24 weeks. When accounting for the fetal state during late gestation (34–28 weeks), we found that males had significantly lower FHR than females in the active fetal state only. Conclusion Results demonstrate significant state, gestational age, and sex-related changes in cardiac activity, somatic activity, and autonomic function as the fetus approaches birth.
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Fetal heart rate, heart rate variability, and heart rate/movement coupling in the Safe Passage Study.
Journal of Perinatology, 2019Co-Authors: Lauren C. Shuffrey, Hein J. Odendaal, Coen Groenewald, Larry Burd, Jyoti Angal, Du Plessis C, Nugent Jd, Amy J Elliott, Michael M Myers, IslerAbstract:To determine normative values for heart rate patterns in healthy fetuses. This research is from the Safe Passage Study conducted by the Prenatal Alcohol and SIDS and Stillbirth (PASS) Network. A standardized protocol assessed fetal heart rate (FHR), heart rate variability (HRV), and movement from 1655 fetuses at three-time points during gestation (20–24 weeks, 28–32 weeks, 34–38 weeks gestation). FHR decreased while HRV increased over gestation. At the latter two ages, males had significantly lower FHR than females while there were no sex differences in FHR at 20–24 weeks. When accounting for the fetal state during late gestation (34–28 weeks), we found that males had significantly lower FHR than females in the active fetal state only. Results demonstrate significant state, gestational age, and sex-related changes in cardiac activity, somatic activity, and autonomic function as the fetus approaches birth.
Larry Burd - One of the best experts on this subject based on the ideXlab platform.
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Fetal heart rate, heart rate variability, and heart rate/movement coupling in the Safe Passage Study
Journal of Perinatology, 2019Co-Authors: Lauren C. Shuffrey, Hein J. Odendaal, Carlie Plessis, Coen Groenewald, Larry Burd, Jyoti Angal, J. David Nugent, Amy J Elliott, Michael M Myers, Joseph R. IslerAbstract:Objective To determine normative values for heart rate patterns in healthy fetuses. Methods This research is from the Safe Passage Study conducted by the Prenatal Alcohol and SIDS and Stillbirth (PASS) Network. A standardized protocol assessed fetal heart rate (FHR), heart rate variability (HRV), and movement from 1655 fetuses at three-time points during gestation (20–24 weeks, 28–32 weeks, 34–38 weeks gestation). Results FHR decreased while HRV increased over gestation. At the latter two ages, males had significantly lower FHR than females while there were no sex differences in FHR at 20–24 weeks. When accounting for the fetal state during late gestation (34–28 weeks), we found that males had significantly lower FHR than females in the active fetal state only. Conclusion Results demonstrate significant state, gestational age, and sex-related changes in cardiac activity, somatic activity, and autonomic function as the fetus approaches birth.
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Fetal heart rate, heart rate variability, and heart rate/movement coupling in the Safe Passage Study.
Journal of Perinatology, 2019Co-Authors: Lauren C. Shuffrey, Hein J. Odendaal, Coen Groenewald, Larry Burd, Jyoti Angal, Du Plessis C, Nugent Jd, Amy J Elliott, Michael M Myers, IslerAbstract:To determine normative values for heart rate patterns in healthy fetuses. This research is from the Safe Passage Study conducted by the Prenatal Alcohol and SIDS and Stillbirth (PASS) Network. A standardized protocol assessed fetal heart rate (FHR), heart rate variability (HRV), and movement from 1655 fetuses at three-time points during gestation (20–24 weeks, 28–32 weeks, 34–38 weeks gestation). FHR decreased while HRV increased over gestation. At the latter two ages, males had significantly lower FHR than females while there were no sex differences in FHR at 20–24 weeks. When accounting for the fetal state during late gestation (34–28 weeks), we found that males had significantly lower FHR than females in the active fetal state only. Results demonstrate significant state, gestational age, and sex-related changes in cardiac activity, somatic activity, and autonomic function as the fetus approaches birth.
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fetal heart rate heart rate variability and heart rate movement coupling in the Safe Passage study
Journal of Perinatology, 2019Co-Authors: Lauren C. Shuffrey, Hein J. Odendaal, Carlie Plessis, Coen Groenewald, Larry Burd, Jyoti Angal, Amy J Elliott, Michael M Myers, David J. Nugent, Joseph R. IslerAbstract:To determine normative values for heart rate patterns in healthy fetuses. This research is from the Safe Passage Study conducted by the Prenatal Alcohol and SIDS and Stillbirth (PASS) Network. A standardized protocol assessed fetal heart rate (FHR), heart rate variability (HRV), and movement from 1655 fetuses at three-time points during gestation (20–24 weeks, 28–32 weeks, 34–38 weeks gestation). FHR decreased while HRV increased over gestation. At the latter two ages, males had significantly lower FHR than females while there were no sex differences in FHR at 20–24 weeks. When accounting for the fetal state during late gestation (34–28 weeks), we found that males had significantly lower FHR than females in the active fetal state only. Results demonstrate significant state, gestational age, and sex-related changes in cardiac activity, somatic activity, and autonomic function as the fetus approaches birth.
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cardiorespiratory physiology in the Safe Passage study protocol methods and normative values in unexposed infants
Acta Paediatrica, 2017Co-Authors: Michael M Myers, Hein J. Odendaal, Coen Groenewald, Larry Burd, Jyoti Angal, Joseph R. Isler, Amy J Elliott, James David Nugent, Joel S C Yang, Kim A DukesAbstract:AIM: The Safe Passage Study, conducted by the Prenatal Alcohol in SIDS and Stillbirth Network, is investigating contributions of prenatal alcohol exposure to foetal and infant demise. This current report presents physiological data from full-term infants with no prenatal exposure to alcohol or maternal smoking. METHODS: Data are from 666 infants from the Northern Plains (North and South Dakota) and South Africa. A standardised protocol assessed cardiorespiratory function during baseline and head-up tilts shortly after birth and at one month of age. RESULTS: Analyses revealed significant increases in heart rate and decreases in BP from the newborn to one-month time period as well as diminished heart rate responses to head-up tilt in one-month-old infants. CONCLUSION: The Safe Passage Study was successful in characterising physiology in a large number of infants at sites known to have elevated risks for SIDS. Results demonstrate that even with low prenatal adverse exposures, there are significant changes in cardiorespiratory function as infants enter the window of increased risk for SIDS.
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the Safe Passage study design methods recruitment and follow up approach
Paediatric and Perinatal Epidemiology, 2014Co-Authors: Kimberly A Dukes, Larry Burd, Amy J Elliott, William P Fifer, Rebecca D Folkerth, Gary D V Hankins, Dale Hereld, Howard J HoffmanAbstract:Background: The Safe Passage Study is a large, prospective, multidisciplinary study designed to (1) investigate the association between prenatal alcohol exposure, sudden infant death syndrome (SIDS), and stillbirth, and (2) determine the biological basis of the spectrum of phenotypic outcomes from exposure, as modified by environmental and genetic factors that increase the risk of stillbirth, SIDS, and in surviving children, fetal alcohol spectrum disorders. Methods: The results provided are based on an interim assessment of 6004 women enrolled, out of the 12 000 projected, from the Northern Plains, US, and Cape Town, South Africa, areas known to be of high risk for maternal drinking during pregnancy. Research objectives, study design, and descriptive statistics, including consent, recruitment, and retention information, are provided. Results: Overall visit compliance is 87%, and includes prenatal, delivery/newborn, and postnatal contacts through 1 year post-delivery. Pregnancy outcome ascertainment is 98% prior to medical chart review; less than 2% of women withdraw. Consent for the use of DNA and placental tissue exceed 94%, and consent to participate in the autopsy portion of the study is 71%. Conclusions: The Safe Passage Study is the first multi-site study of SIDS and stillbirth to integrate prospectively collected exposure information with multidisciplinary biological information in the same maternal and fetal/ infant dyad using a common protocol. Essential components of the study design and its success are close ties to the community and rigorous systems and processes to ensure compliance with the study protocol and procedures.
