Behavioral states and breathing activity in the fetus near term

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Abstract
Measurement of fetal breathing movements (FBM) has found considerable clinical interest since it is thought to be predictive of fetal health or compromise. Assessments of FBM within short observation periods of 30 min duration are suspect of being influenced substantially by factors other than fetal distress and therefore may not be representative for fetal health state. It was assumed that fetal state behavior might have a major influence on FBM assessment. Simultaneous recordings of FHR (fetal heart rate) and fetal motor activity (for assessing of state behavior) and FBM were performed in 20 patients with uncomplicated pregnancies near term. Duration of recordings was 107.3 .+-. 39.5 min. In 24.3 .+-. 16.5% of time (range 0.75-49.0%) FBM were present in the total recordings. During 15 periods of quiet sleep FBM were seen in 13.8% of time (range 0-57%). In nearly half of these periods no breathing activity at all was seen. But only in 2 of these periods stop and start of breathing movements coincided with the beginning and end of the period; in 3 of these periods only stop or start of breathing movements coincided with the beginning or end of the period. During 8 periods of active sleep FBM were seen in 29.5% of time (range 5.4-43.7%). In none of these sleep periods no breathing at all could be seen. Duration of nonbreathing periods ranged from 6 s to 46 min. Nonbreathing periods of 30 min and longer contributed only 0.22% to the total number of nonbreathing periods but 10% to total nonbreathing time. Sporadic measurement of FBM for 30 min duration may be inadequate for diagnosis of fetal health or compromise, because the proportion of FBM in 30 min observation periods may be influenced substantially by factors other than fetal health state.

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