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1.
Infant Behav Dev ; 76: 101960, 2024 May 30.
Article in English | MEDLINE | ID: mdl-38820859

ABSTRACT

Social touch through infant holding, skin-to-skin contact, and infant carrying (babywearing) decreases infant distress and promotes secure attachment. Unknown is the extent to which these effects are the result of the activation of C-Tactile afferents (CTs), the constellation of nerve fibers associated with affective touch, primarily located in the head and trunk of the body. The purpose of the present study was to compare dynamic touch (CTs activated) to static touch (CTs less activated) during a babywearing procedure among infants experiencing Neonatal Opioid Withdrawal Syndrome (NOWS). NOWS is a spectrum of clinical symptoms, including elevated heart rate (HR), associated with withdrawal from intrauterine opioid exposure. We hypothesized that stroking an infant's head during babywearing would amplify the pleasurable effect of babywearing as measured by changes in infant HR. Twenty-nine infants in a Neonatal Intensive Care Unit (NICU) in the Southwestern USA were worn in an infant carrier starting at five days old (M = 5.4, SD = 2.6; 46.2 % White, 26.9 % Latinx, 11.5 % Native American) and physiological readings were conducted daily; heart rates of infants and caregivers were taken every 15-seconds for 5-minutes, before, during, and after babywearing (30 min per phase). Each day infants alternated (randomly) in a static touch (hands-free babywearing) or dynamic touch condition (stroking the top of the infants' head at a velocity of 3 cm/s while babywearing). On average, infants completed 3 dynamic and 3 static babywearing sessions. Hospital and research staff participated in babywearing when a parent was not available (31.0 % of infants were exclusively worn by volunteers, 27.6 % were exclusively worn by parents). We analyzed the data using Hierarchical Linear Models due to the 3-level nested design (N = 29 infants, N = 191 readings, N = 11,974 heart rates). Compared to baseline (infant calm/asleep and without contact), infant's HRs significantly declined during and after babywearing, controlling for pharmacological treatment. These effects were significantly stronger during the dynamic touch condition (reduction in HR of 11.17 bpm) compared to the static touch condition (reduction in HR of 3.74 bpm). These effects did not significantly vary by wearer (mother, father, volunteer). However, differences between the dynamic and static conditions were significantly stronger in earlier babywearing sessions, potentially indicating a learning effect. There was evidence for a calming effect among caregivers as well, particularly in the dynamic touch condition, when caregivers were engaged in active touch. Activation of CTs appears to be an important mechanism in the physiological benefits of babywearing and in the symbiotic role of caregiver-infant attachment.

3.
Ann Biomed Eng ; 50(7): 836-846, 2022 Jul.
Article in English | MEDLINE | ID: mdl-35403976

ABSTRACT

Fetal electrocardiogram (ECG) waveform analysis along with cardiac time intervals (CTIs) measurements are critical for the management of high-risk pregnancies. Currently, there is no system that can consistently and accurately measure fetal ECG. In this work, we present a new automatic approach to attenuate the maternal ECG in the frequency domain and enhance it with measurable CTIs. First, the coherent components between the maternal ECG and abdominal ECG were identified and subtracted from the latter in the frequency domain. The residual was then converted into the time domain using the inverse Fourier transform to yield the fetal ECG. This process was improved by averaging multiple beats. Two fetal cardiologists, blinded to the method, assessed the quality of fetal ECG based on a grading system and measured the CTIs. We evaluated the fetal ECG quality of our method and time-based methods using one synthetic dataset, one human dataset available in the public domain, and 37 clinical datasets. Among the 37 datasets analyzed, the mean average (± standard deviation) grade was 3.49 ± 1.22 for our method vs. 2.64 ± 1.26 for adaptive interference cancellation (p-value < 0.001), thus showing the frequency-based fetal ECG extraction was the superior method, as assessed from our clinicians' perspectives. This method has the potential for use in clinical settings.


Subject(s)
Electrocardiography , Fetus , Abdomen , Algorithms , Electrocardiography/methods , Female , Heart , Humans , Pregnancy , Signal Processing, Computer-Assisted
4.
Fetal Diagn Ther ; 47(9): 711-716, 2020.
Article in English | MEDLINE | ID: mdl-32615554

ABSTRACT

INTRODUCTION: Early detection and monitoring for malignant arrhythmias is fundamental to prenatal care in long QT syndrome (LQTS). Recently, we studied the feasibility of isolating the fetal electrocardiogram (fECG) and measuring electrocardiographic intervals with a noninvasive fECG device using blind source separation with reference signal. Our aim was to evaluate the ability of fECG to diagnose LQTS. CASE PRESENTATIONS: We identified 3 cases of clinically suspected LQTS based on fetal echocardiogram (2 had sinus bradycardia, 1 had second-degree atrioventricular block with negative maternal anti-SSA/SSB antibody titers). With institutional review board approval, these patients were prospectively enrolled for fECG acquisition. Offline post-processing generated fECG waveforms and calculated QT intervals. Case 1 and 3 had a maternal history of LQTS. Two of the three fetuses with suspected LQTS had confirmed LQTS by postnatal ECG and genetic testing. FECG was able to identify a prolonged corrected QT interval in both cases. One of these also had fetal magnetocardiography (fMCG), which yielded similar findings to the fECG. The third fetus had a normal fECG; fMCG and postnatal ECG were also normal. CONCLUSIONS: In 3 cases, fECG findings corroborated the diagnosis of LQTS. Noninvasive fECG may offer a novel method for fECG that is portable and more clinically accessible.


Subject(s)
Electrocardiography/methods , Fetal Heart/physiopathology , Long QT Syndrome/diagnostic imaging , Magnetocardiography/methods , Adult , Female , Heart Rate, Fetal/physiology , Humans , Long QT Syndrome/physiopathology , Pregnancy , Prenatal Care , Prenatal Diagnosis , Young Adult
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