| DiPietro et al., 1996 |
Fetal Neurobehavioral Development |
N=31; Fetal activity and fetal heart rate digitized using fetal actocardiograph over 50 min. periods at 20w, 24w, 28w, 32w, 36w, and 38w–39w gestation while maternal abdomen underwent vibroacoustic stimulation; HSUP |
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| Allister et al., 2001 |
The effects of maternal depression on fetal heart rate response to vibroacoustic stimulation |
N=20; FHR monitored using actocardiograph while maternal abdomen underwent vibroacoustic stimulation between 32w–36w gestation; BDI |
Fetuses of depressed mothers had a significantly higher (+) mean and more (+) variable FHR during a baseline period and at the onset of vibroacoustic stimulation than fetuses of nondepressed mothers (p<0.05 for both). Change in FHR following vibroacoustic stimulation was significantly higher (+) for fetuses of nondepressed mothers than depressed (p<0.01). 3–6.5 mins following vibroacoustic stimulation, fetuses of depressed mothers showed significantly greater (+)FHR variability than fetuses of nondepressed mothers (p<0.10), suggesting that the fetuses of depressed mothers were still regulating their hearth rate due to vibroacoustic stimulation while fetuses of nondepressed mothers had returned to baseline.
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| Dieter et al., 2008a |
Maternal depression and anxiety effects on the human fetus: preliminary findings and clinical implications |
N=90: Fetal activity observed via ultrasound for 5 continuous minutes between 18w and 36w gestation and movements were categorized; CES-D, STAI |
Fetuses of depressed mothers spent a greater (+) percent of time active than non-depressed counterparts (p<0.01). Fetal activity was significantly positively correlated (+) with both maternal depression (r=0.30, p<0.01), anxiety (r=0.20, p<0.05), as well as their combined effects (r2=0.35, p<0.05).
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| DiPietro et al., 2002 |
Maternal stress and affect influence fetal neurobehavioral development |
N=52; Fetal activity monitored via fetal actocardiograph at 24w, 30w, and 36w gestation; AIM, DSI, PES – utilized to form a composite score |
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| Monk et al., 2004 |
Fetal heart rate reactivity differs by women’s psychiatric status: an early marker for developmental risk? |
N=57; Fetal activity monitored via actocardiograph as well as maternal EKG, BP, respiration, and salivary cortisol between 36w–38w gestation during a lab- induced stressor; SCID and STAI during 2nd trimester |
Significant positive association (+)between maternal diagnostic group and FHR baseline reactivity from baseline to lab-induced stressor (p=0.04). Fetuses of depressed mothers had significantly greater (+) FHR increases from baseline to lab-induced stressor compared to fetuses of women with anxiety disorder, healthy (no psychiatric disorder) low-anxiety women, and healthy middle-anxiety women (p<0.05, p<0.01, p<0.05, respectively). Fetuses of healthy high-anxiety women had significantly higher (+) FHR increases compared to fetuses of women with anxiety disorder and healthy, low- anxiety women (p<0.05 for both).
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| Monk et al., 2000 |
Maternal stress responses and anxiety during pregnancy: effects on fetal heart rate |
N=17; Fetal activity monitored via actocardiograph as well as maternal EKG, BP, and respiration between 35w–38w gestation during a lab- induced stressor; STPI |
Fetuses of above-average anxiety mothers had significantly greater (+)FHR increases from baseline to the lab- induced stressor than the fetuses of below-average anxiety mothers (p<0.05). Fetuses of above-average anxiety mothers had a significantly higher (+)than baseline FHR during the entire lab- induced stressor period (p<0.01), while fetuses of below-average anxiety mothers did not show a significantly different than baseline FHR at any point during this period.
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| Monk et al., 2003 |
Effects of women’s stress- elicited physiological activity and chronic anxiety on fetal heart rate |
N=32; Fetal activity monitored via actocardiograph as well as maternal EKG, BP, and respiration between 35w–38w gestation during a lab- induced stressor; STAI |
FHR changes during recovery from lab-induced stressor were significantly positively associated (+) with women’s concurrently collected HR and BP changes (r=0.63, p<0.05). Changes in FHR from baseline to lab- induced stressor were significantly positively correlated (+) with women’s anxiety scores (r=0.39, p<0.05). Changes in FHR from lab-induced stressor to recovery were significantly inversely associated (−) with women’s anxiety scores (r=0.39, p<0.05).
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| Monk et al., in preparation |
Prenatal origins of self- regulation: fetal sensory responses differ by women’s psychiatric status |
N=113; Fetal activity monitored via actocardiograph as well as maternal EKG, BP, respiration, and salivary cortisol between 36w–38w gestation during a lab- induced stressor; SCID during 2nd trimester |
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| DiPietro et al., 2003 |
Fetal response to induced maternal stress |
N=137; Fetal activity monitored via actocardiograph as well as maternal EKG and SCL at 24w and 36w gestation during a lab-induced stressor |
|
| Groome et al., 1995 |
Maternal anxiety during pregnancy: effect on fetal behavior at 38 to 40 weeks of gestation |
N=18; Fetal activity monitored for 60 consecutive minutes using fetal actocardiograph at 38w–40w to define in utero “sleep states;” STAI |
As maternal trait anxiety increased, fetuses spent increasingly more time (+)in quiet sleep (r=0.627, p=0.005) and were less active (−) in active sleep (r=− 0.620, p=0.006). Significant positive linear relationship (+) between increasing maternal state anxiety scores and greater percent quiet sleep (r=0.633, p=0.005).
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| Dieter et al., 2008b |
Maternal depression and anxiety effects on the human fetus: preliminary findings and clinical implications |
N=32; Fetal activity monitored with fetal actocardiograph while maternal abdomen underwent vibroacoustic stimulation at 33w gestation; BDI-II, BAI |
Significant group effect of increased maternal depression across baseline, stimulation, and post-stimulation on total fetal movement (−) and FHR (−)(p=0.05). Fetuses of depressed mothers showed a significantly lower (−) mean baseline heart rate than those of non-depressed mothers (p=0.04). Greater proportion (+) of fetuses of depressed mothers reached habituation criterion than those of non-depressed mothers and required fewer trials for habituation (p=0.02). Comorbid anxiety and depression explained 34% of the variance in habituation (p<0.01).
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| DiPietro et al., 1996 |
Development of fetal movement – fetal heart rate coupling from 20 weeks through term |
N=31; Fetal activity and fetal heart rate digitized using fetal actocardiograph over 50 min. periods at 20w, 24w, 28w, 32w, 36w, and 38w–39w gestation while maternal abdomen underwent vibroacoustic stimulation; HSUP |
Higher maternal perceived stress was significantly inversely associated (−) with FM-FHR coupling (p<0.01). Faster maternal heart rates were significantly inversely associated (−) with FM-FHR coupling latency (p<0.05).
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| DiPietro et al., 1998 |
Fetal neurobehavioral development: associations with socioeconomic class and fetal sex |
N=103; Fetal activity and fetal heart rate digitized using fetal actocardiograph over 50 min. periods at 24w, 30w, and 36w gestation; group stratification by maternal SES |
SES was significantly positively associated (+) with FHR variability (p<0.01). Fetuses of low SES mothers showed significantly less decrease (−) in FHR over gestation than those of higher SES (p<0.05). SES was significantly positively associated (+) with overall fetal movement and movement vigor (p<0.05). SES was significantly positively associated (+) with degree of FM-FHR coupling (p<0.05).
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| Sandman et al., 1999 |
Maternal corticotropin- releasing hormone and habituation in the human fetus |
N=33; Fetal activity monitored via fetal actocardiograph while maternal abdomen underwent vibroacoustic stimulation and maternal plasma CRH through blood draw between 31w–32w gestation. |
FHR response to habituation was significantly inversely related (−) to maternal CRH concentration (r=−0.41, p=0.02). Significant positive linear association (+) between maternal CRH and FHR (r=0.50, p<0.005).
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| Field et al., 2004 |
Prenatal maternal cortisol, fetal activity and growth |
N=131; Fetal activity and estimated fetal weight coded from ultrasound, cortisol collected through urinalysis between 20w–28w gestation; CES-D, STAI |
Maternal cortisol levels significantly positively associated (+) with fetal activity and inversely (−) with fetal weight (r=0.123, p<0.05, r=−0.01, p<0.005, respectively).
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| DiPietro et al., in press |
Fetal motor activity is associated with maternal cortisol |
N=92; Fetal activity monitoring via fetal actocardiograph and salivary cortisol collection at 32w and 36w gestation; PSS, PNAS, STAI, PES |
Higher maternal cortisol significantly positively associated (+) with more fetal motor vigor at 32w (r=0.39, p<0.01), and 36w (r=0.27, p<0.05) and, at 32w, the amount of time fetuses spent moving in 50 min observation at (r=0.33, p<0.05).
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| Sandman et al., 2003 |
Maternal hypothalamic- pituitary-adrenal disregulation during the third trimester influences human fetal responses |
N=135; Fetal activity monitored via fetal actocardiograph and maternal plasma ACTH and β-endorphin through blood draw at 32w gestation |
Increase in maternal endocrine dysregulation (uncoupling of ACTH and βE) significantly positively related (+)to FHR (r=0.17, p<0.05), however no significance between FHR and individual endocrine concentrations.
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| Teixeira et al., 1999 |
Association between maternal anxiety in pregnancy and increased uterine artery resistance index: cohort based study |
N=100; Uterine artery flow assessed by color Doppler ultrasound at 32w gestation; STAI |
Significant positive association (+)found between uterine artery resistance index and state (r=0.31, p<0.002) and trait anxiety (r=0.28, p<0.005). Presence of notched waveform was significantly positively associated (+)with state anxiety (p<0.02).
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| Kent et al., 2002 |
Uterine artery resistance and anxiety in the second trimester of pregnancy |
N=96; Uterine artery flow assessed by color Doppler ultrasound at 20w gestation; HAD |
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| DiPietro et al., 2008 |
Fetal responses to induced maternal relaxation during pregnancy |
N=99; Fetal activity monitored via actocardiograph as well as maternal EKG, SCL, respiration, and uterine artery flow as assessed by color Doppler ultrasound at 32w gestation during a lab- induced maternal relaxation session; salivary cortisol collected at 6 points during session |
Cortisol levels declined significantly (−)period-to-period from arrival through post-recovery (p<0.0001). No significant change in uterine artery resistance from baseline to lab-induced relaxation. FHR significantly declined (−) over time throughout the protocol (p<0.05), though decline was most pronounced from baseline to lab-induced relaxation (p<0.001). Fetal movement significantly decreased (−) from baseline to lab-induced relaxation and then significantly increased (+) from lab-induced relaxation to recovery (p<0.0001 for both). FM-FHR coupling significantly increased (+) from baseline to lab- induced relaxation and then significantly decreased (−) from lab-induced relaxation to recovery. Fetuses of women who reported greater psychological relaxation to the procedure showed significantly greater (+) FHR reactivity and recovery (r=0.27, p<0.001, r=0.20, p<0.05, respectively). Maternal HR recovery was significantly positively related (+) to both FHR and FHR variability (r=0.43, p<0.001, r=0.21, p<0.05, respectively). Significant positive association (+)between the degree of cortisol reactivity and FM suppression (r=0.31, p<0.05).
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