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The aim of this study was to evaluate the effect of anthropometric and metabolic factors on the fetal autonomic nervous system (ANS) in uncomplicated pregnancies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 184 pregnant women in the second or third trimester were included, and for 104 women, maternal insulin sensitivity (ISI) was determined. Fetal heart rate (HR) and heart rate variability (HRV) were determined by magnetic recording. Associations of maternal prepregnancy BMI, weight gain, and ISI with fetal HR and HRV were evaluated by ANCOVA, partial correlation, and mediation analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>HR was increased and HRV decreased in fetuses of mothers with overweight or obesity in comparison to normal\u2010weight mothers. Fetal HR was negatively correlated with maternal weight gain. Maternal prepregnancy BMI was positively correlated with fetal high frequency and was negatively correlated with low frequency and low\/high frequency ratio. Maternal ISI showed a negative correlation with fetal HR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The results show that the fetal ANS is sensitive to alterations of prepregnancy BMI, weight changes, and glucose metabolism. These findings highlight the importance of the\u00a0intrauterine environment on the developing ANS and the possible programming of obesity.<\/jats:p><\/jats:sec>","DOI":"10.1002\/oby.22664","type":"journal-article","created":{"date-parts":[[2019,12,20]],"date-time":"2019-12-20T08:12:56Z","timestamp":1576829576000},"page":"114-121","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Maternal Weight, Weight Gain, and Metabolism are Associated with Changes in Fetal Heart Rate and Variability"],"prefix":"10.1002","volume":"28","author":[{"given":"Haliza","family":"Mat Husin","sequence":"first","affiliation":[{"name":"fMEG Center Helmholtz Center Munich University of T\u00fcbingen T\u00fcbingen Germany"},{"name":"Graduate Training Centre of Neuroscience International Max Planck Research School University of T\u00fcbingen T\u00fcbingen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Franziska","family":"Schleger","sequence":"additional","affiliation":[{"name":"fMEG Center Helmholtz Center Munich University of T\u00fcbingen T\u00fcbingen Germany"},{"name":"Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Centre Munich (IDM) at the University of T\u00fcbingen T\u00fcbingen Germany"},{"name":"German Center for Diabetes Research (DZD e.V.) 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