{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:08:06Z","timestamp":1788394086832,"version":"build-2803163510"},"reference-count":40,"publisher":"IOP Publishing","issue":"8","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":1,"URL":"https:\/\/iopscience.iop.org\/info\/page\/text-and-data-mining"}],"funder":[{"name":"Eindhoven MedTech Innovation Center"},{"name":"Nemo Healthcare B.V."},{"name":"Top Sector Holland High Tech","award":["PPS23-2-03529539"],"award-info":[{"award-number":["PPS23-2-03529539"]}]},{"name":"Maxima Medical Center, Veldhoven"},{"name":"PPP Allowance TKI HTSM","award":["PPS23-2-03529539"],"award-info":[{"award-number":["PPS23-2-03529539"]}]},{"name":"M\u00e1xima Fund","award":["PPS23-2-03529539"],"award-info":[{"award-number":["PPS23-2-03529539"]}]},{"name":"University Fund Eindhoven","award":["PPS23-2-03529539"],"award-info":[{"award-number":["PPS23-2-03529539"]}]}],"content-domain":{"domain":["iopscience.iop.org"],"crossmark-restriction":false},"short-container-title":["Physiol. Meas."],"published-print":{"date-parts":[[2026,8,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:italic>Objective<\/jats:italic>\n                    . Fetal electrocardiography (fECG) provides beat-to-beat cardiac information, offering the potential to improve the assessment of fetal response to uterine activity. However, the accuracy of fECG-derived cardiotocograms depends on signal quality. Scalp electrode recordings offer reliable fECG but are invasive and measurable only during labor. In contrast, non-invasive fECG measurements suffer from a low signal-to-noise ratio and maternal interference. To advance research on the use of non-invasive fECG, there is a need for large datasets with non-invasive multi-channel fECG recorded simultaneously with a clear reference fECG, such as from a scalp electrode.\n                    <jats:italic>Approach<\/jats:italic>\n                    . We propose a method to address this data scarcity by synthesizing multi-channel fECG signals by modifying inter-beat intervals based on a target fetal heart rate (fHR). The proposed method adjusts the duration of the TP segments between consecutive fECG complexes to effectively match the inter-beat intervals of the target fHR. The adjusted multi-channel TP segments are generated by a generative model that has learned the structure of the TP segments in our dataset. The morphology of the fetal QRS complexes remains unchanged. The fidelity of the synthesized signals is evaluated using signal quality indices (SQIs) and fHR estimates.\n                    <jats:italic>Main results<\/jats:italic>\n                    . Most SQIs computed on the input and synthesized signals exhibited strong correlation (\n                    <jats:inline-formula>\n                      <jats:tex-math>\n                        \n                      <\/jats:tex-math>\n                      <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" overflow=\"scroll\">\n                        <mml:mrow>\n                          <mml:mi>r<\/mml:mi>\n                          <mml:mo>&gt;<\/mml:mo>\n                          <mml:mn>0.9<\/mml:mn>\n                        <\/mml:mrow>\n                      <\/mml:math>\n                    <\/jats:inline-formula>\n                    ), with low mean absolute differences. The error in the standard deviation of the estimated fHR and that of the target fHR was\n                    <jats:inline-formula>\n                      <jats:tex-math>\n                        \n                      <\/jats:tex-math>\n                      <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" overflow=\"scroll\">\n                        <mml:mrow>\n                          <mml:mo>\u00b1<\/mml:mo>\n                          <mml:mn>3.35<\/mml:mn>\n                        <\/mml:mrow>\n                      <\/mml:math>\n                    <\/jats:inline-formula>\n                    BPM. Morphology-based SQIs exhibited strong correlations (\n                    <jats:inline-formula>\n                      <jats:tex-math>\n                        \n                      <\/jats:tex-math>\n                      <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" overflow=\"scroll\">\n                        <mml:mrow>\n                          <mml:mi>r<\/mml:mi>\n                          <mml:mo>&gt;<\/mml:mo>\n                          <mml:mn>0.9<\/mml:mn>\n                        <\/mml:mrow>\n                      <\/mml:math>\n                    <\/jats:inline-formula>\n                    ), validating the preservation of fetal QRS complexes.\n                    <jats:italic>Significance<\/jats:italic>\n                    . Our approach generates realistic multi-channel fECG signals that match the target fHR patterns, supporting data augmentation and algorithm development for fetal monitoring. It addresses the scarcity of multi-channel fECG measurements with a clean reference available for algorithm development. It could enhance the robustness of data-driven and source separation methods.\n                  <\/jats:p>","DOI":"10.1088\/1361-6579\/ae98e1","type":"journal-article","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T22:55:32Z","timestamp":1786575332000},"page":"085030","update-policy":"https:\/\/doi.org\/10.1088\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Synthesis of multi-channel fetal ECG using generative modeling"],"prefix":"10.1088","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-3607-018X","authenticated-orcid":true,"given":"Swedha","family":"Sankaranarayanan","sequence":"first","affiliation":[{"name":"Eindhoven University of Technology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4306-8673","authenticated-orcid":false,"given":"Marta","family":"Regis","sequence":"additional","affiliation":[{"name":"Eindhoven University of Technology"},{"name":"Research and Medical Innovation, M\u00e1xima Medical Centre"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5350-3267","authenticated-orcid":false,"given":"Judith","family":"OEH van Laar","sequence":"additional","affiliation":[{"name":"Eindhoven University of Technology"},{"name":"M\u00e1xima Medical Centre"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5805-5333","authenticated-orcid":false,"given":"M","family":"Beatrijs van der Hout-van der Jagt","sequence":"additional","affiliation":[{"name":"Eindhoven University of Technology"},{"name":"Eindhoven University of Technology"},{"name":"M\u00e1xima Medical Centre"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2392-6098","authenticated-orcid":true,"given":"Rik","family":"Vullings","sequence":"additional","affiliation":[{"name":"Eindhoven University of Technology"},{"name":"Nemo Healthcare B.V."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"266","published-online":{"date-parts":[[2026,9,1]]},"reference":[{"key":"pmeaae98e1bib1","doi-asserted-by":"publisher","first-page":"409","DOI":"10.1016\/0010-4825(89)90076-0","type":"journal-article","article-title":"Spectral analysis of the fetal electrocardiogram","volume":"19","author":"Abboud","year":"1989","journal-title":"Comput. Biol. Med."},{"key":"pmeaae98e1bib2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD006066.pub2","type":"journal-article","article-title":"Continuous cardiotocography (CTG) as a form of electronic fetal monitoring (EFM) for fetal assessment during labour","volume":"2","author":"Alfirevic","year":"2017","journal-title":"Cochrane Database Systematic Rev."},{"key":"pmeaae98e1bib3","doi-asserted-by":"publisher","first-page":"534","DOI":"10.1016\/S0140-6736(01)05703-8","type":"journal-article","article-title":"Cardiotocography only versus cardiotocography plus ST analysis of fetal electrocardiogram for intrapartum fetal monitoring: a Swedish randomised controlled trial","volume":"358","author":"Amer-W\u00e5hlin","year":"2001","journal-title":"Lancet"},{"key":"pmeaae98e1bib4","doi-asserted-by":"publisher","first-page":"627","DOI":"10.1088\/0967-3334\/37\/5\/627","type":"journal-article","article-title":"An open-source framework for stress-testing non-invasive foetal ECG extraction algorithms","volume":"37","author":"Andreotti","year":"2016","journal-title":"Physiol. Meas."},{"key":"pmeaae98e1bib5","doi-asserted-by":"publisher","first-page":"2793","DOI":"10.1109\/TBME.2017.2675543","type":"journal-article","article-title":"Non-invasive fetal ECG signal quality assessment for multichannel heart rate estimation","volume":"64","author":"Andreotti","year":"2017","journal-title":"IEEE Trans. Biomed. Eng."},{"key":"pmeaae98e1bib6","doi-asserted-by":"publisher","first-page":"1307","DOI":"10.1111\/j.1471-0528.1999.tb08187.x","type":"journal-article","article-title":"Inconsistencies in classification by experts of cardiotocograms and subsequent clinical decision","volume":"106","author":"Ayres-de Campos","year":"1999","journal-title":"BJOG"},{"key":"pmeaae98e1bib7","doi-asserted-by":"publisher","DOI":"10.1016\/j.dib.2020.106399","type":"journal-article","article-title":"Annotated real and synthetic datasets for non-invasive foetal electrocardiography post-processing benchmarking","volume":"33","author":"Baldazzi","year":"2020","journal-title":"Data Brief"},{"key":"pmeaae98e1bib8","doi-asserted-by":"publisher","first-page":"178","DOI":"10.1002\/pd.5412","type":"journal-article","article-title":"Noninvasive fetal electrocardiography for the detection of fetal arrhythmias","volume":"39","author":"Behar","year":"2019","journal-title":"Prenatal Diagn."},{"key":"pmeaae98e1bib9","doi-asserted-by":"publisher","first-page":"1537","DOI":"10.1088\/0967-3334\/35\/8\/1537","type":"journal-article","article-title":"An ECG simulator for generating maternal-foetal activity mixtures on abdominal ECG recordings","volume":"35","author":"Behar","year":"2014","journal-title":"Physiol. Meas."},{"key":"pmeaae98e1bib10","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1016\/S0029-7844(97)83837-9","type":"journal-article","article-title":"Electrical activity of the human uterus during pregnancy as recorded from the abdominal surface","volume":"90","author":"Buhimschi","year":"1997","journal-title":"Obstetrics Gynecology"},{"key":"pmeaae98e1bib11","doi-asserted-by":"publisher","first-page":"2675","DOI":"10.1109\/TBME.2009.2028694","type":"journal-article","article-title":"Quantifying the PR interval pattern during dynamic exercise and recovery","volume":"56","author":"Cabasson","year":"2009","journal-title":"IEEE Trans. Biomed. Eng."},{"key":"pmeaae98e1bib12","doi-asserted-by":"publisher","DOI":"10.1177\/20480040221096209","type":"journal-article","article-title":"Measurement of the cardiac time intervals of the fetal ECG utilising a computerised algorithm: a retrospective observational study","volume":"11","author":"Chivers","year":"2022","journal-title":"JRSM Cardiovascular Dis."},{"key":"pmeaae98e1bib13","doi-asserted-by":"publisher","first-page":"61","DOI":"10.3390\/signals6040061","type":"journal-article","article-title":"Non-invasive techniques for fECG analysis in fetal heart monitoring: a systematic review","volume":"6","author":"Dash","year":"2025","journal-title":"Signals"},{"key":"pmeaae98e1bib14","first-page":"4","type":"journal-article","article-title":"DAISY: a database for identification of systems","volume":"38","author":"De Moor","year":"1997","journal-title":"J. A"},{"key":"pmeaae98e1bib15","doi-asserted-by":"publisher","DOI":"10.1016\/j.eurox.2020.100120","type":"journal-article","article-title":"Low sensitivity of the new FIGO classification system for electronic fetal monitoring to identify fetal acidosis in the second stage of labor","volume":"9","author":"Ekeng\u00e5rd","year":"2021","journal-title":"Eur. J. Obstetrics Gynecology Reprod. Biol.: X"},{"key":"pmeaae98e1bib16","doi-asserted-by":"publisher","first-page":"ytac213","DOI":"10.1093\/ehjcr\/ytac213","type":"journal-article","article-title":"Pharmacological cardioversion of supraventricular tachycardia in pregnancy during continuous electrophysiological foetal monitoring: a case report","volume":"6","author":"Francinetti","year":"2022","journal-title":"Eur. Heart J. - Case Rep."},{"key":"pmeaae98e1bib17","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1109\/10.43620","type":"journal-article","article-title":"A comparison of the noise sensitivity of nine QRS detection algorithms","volume":"37","author":"Friesen","year":"1990","journal-title":"IEEE Trans. Biomed. Eng."},{"key":"pmeaae98e1bib18","doi-asserted-by":"publisher","first-page":"383","DOI":"10.1515\/bmt-2011-0130","type":"journal-article","article-title":"Determination of fetal heart rate from abdominal signals: evaluation of beat-to-beat accuracy in relation to the direct fetal electrocardiogram","volume":"57","author":"Jezewski","year":"2012","journal-title":"Biomed. Tech.\/Biomed. Eng."},{"key":"pmeaae98e1bib19","doi-asserted-by":"publisher","first-page":"855","DOI":"10.1109\/TBME.2005.863945","type":"journal-article","article-title":"Comparison of doppler ultrasound and direct electrocardiography acquisition techniques for quantification of fetal heart rate variability","volume":"53","author":"Jezewski","year":"2006","journal-title":"IEEE Trans. Biomed. Eng."},{"key":"pmeaae98e1bib20","doi-asserted-by":"publisher","first-page":"244","DOI":"10.1177\/014107689809100503","type":"journal-article","article-title":"Electronic fetal heart rate monitoring: retrospective reflections on a twentieth-century technology","volume":"91","author":"Kennedy","year":"1998","journal-title":"J. R. Soc. Med."},{"key":"pmeaae98e1bib21","article-title":"Auto-encoding variational Bayes","author":"Kingma","year":"2014","type":"preprint"},{"key":"pmeaae98e1bib22","doi-asserted-by":"publisher","first-page":"1387","DOI":"10.1111\/aogs.13873","type":"journal-article","article-title":"Intrapartum non-invasive electrophysiological monitoring: a prospective observational study","volume":"99","author":"Lempersz","year":"2020","journal-title":"Acta Obstet. et Gynecol. Scand."},{"key":"pmeaae98e1bib23","doi-asserted-by":"publisher","first-page":"1412","DOI":"10.3390\/s25051412","type":"journal-article","article-title":"Review of non-invasive fetal electrocardiography monitoring techniques","volume":"25","author":"Li","year":"2025","journal-title":"Sensors"},{"key":"pmeaae98e1bib24","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1088\/0967-3334\/28\/4\/004","type":"journal-article","article-title":"A robust fetal ECG detection method for abdominal recordings","volume":"28","author":"Martens","year":"2007","journal-title":"Physiol. Meas."},{"key":"pmeaae98e1bib25","doi-asserted-by":"publisher","first-page":"200","DOI":"10.1038\/s41597-020-0538-z","type":"journal-article","article-title":"Fetal electrocardiograms, direct and abdominal with reference heartbeat annotations","volume":"7","author":"Matonia","year":"2020","journal-title":"Sci. Data"},{"key":"pmeaae98e1bib26","article-title":"Unrolled generative adversarial networks","author":"Metz","year":"2017","type":"conference-proceedings"},{"key":"pmeaae98e1bib27","first-page":"pp 230","type":"conference-proceedings","article-title":"A real-time QRS detection algorithm","author":"Pan","year":"1985"},{"key":"pmeaae98e1bib28","doi-asserted-by":"publisher","DOI":"10.13026\/c4n5-3b04","type":"conference-proceedings","article-title":"NInFEA: non-invasive multimodal foetal ECG-Doppler dataset for antenatal cardiology research","author":"Pani","year":"2020"},{"key":"pmeaae98e1bib29","doi-asserted-by":"publisher","first-page":"6092","DOI":"10.1109\/IEMBS.2006.259845","type":"conference-proceedings","article-title":"Heart rate detection in low amplitude non-invasive fetal ecg recordings","author":"Peters","year":"2006"},{"key":"pmeaae98e1bib30","doi-asserted-by":"publisher","first-page":"792","DOI":"10.1038\/s44360-026-00096-z","type":"journal-article","article-title":"PhysioNet as a global platform for biomedical research","volume":"1","author":"Pollard","year":"2026","journal-title":"Nat. Health"},{"key":"pmeaae98e1bib31","doi-asserted-by":"publisher","DOI":"10.1098\/rsif.2022.0012","type":"journal-article","article-title":"Robustness of electrocardiogram signal quality indices","volume":"19","author":"Rahman","year":"2022","journal-title":"J. R. Soc. Interface"},{"key":"pmeaae98e1bib32","article-title":"OSET: the open-source electrophysiological toolbox","author":"Sameni","year":"2006\u20132023","type":"other"},{"key":"pmeaae98e1bib33","doi-asserted-by":"publisher","first-page":"4","DOI":"10.2174\/1876536X01003010004","type":"journal-article","article-title":"A review of fetal ECG signal processing; issues and promising directions","volume":"3","author":"Sameni","year":"2010","journal-title":"Open Pacing, Electrophysiol. Ther. J."},{"key":"pmeaae98e1bib34","doi-asserted-by":"publisher","first-page":"1557","DOI":"10.1111\/j.1471-0528.2008.01857.x","type":"journal-article","article-title":"Sensitivity and specificity of intrapartum computerised FIGO criteria for cardiotocography and fetal scalp pH during labour: multicentre, observational study","volume":"115","author":"Schiermeier","year":"2008","journal-title":"BJOG"},{"key":"pmeaae98e1bib35","article-title":"Non-invasive fetal electrocardiogram database","author":"Sober","year":"2007","type":"other"},{"key":"pmeaae98e1bib36","article-title":"Score-based generative modeling through stochastic differential equations","author":"Song","year":"2021","type":"conference-proceedings"},{"key":"pmeaae98e1bib37","doi-asserted-by":"publisher","first-page":"1235","DOI":"10.1046\/j.1471-0528.2002.01057.x","type":"journal-article","article-title":"Multicentre study of fetal cardiac time intervals using magnetocardiography","volume":"109","author":"Stinstra","year":"2002","journal-title":"BJOG"},{"key":"pmeaae98e1bib38","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1038\/s41597-021-00811-3","type":"journal-article","article-title":"A non-invasive multimodal foetal ECG-Doppler dataset for antenatal cardiology research","volume":"8","author":"Sulas","year":"2021","journal-title":"Sci. Data"},{"key":"pmeaae98e1bib39","doi-asserted-by":"publisher","first-page":"1607","DOI":"10.1088\/0967-3334\/35\/8\/1607","type":"journal-article","article-title":"An efficient unsupervised fetal QRS complex detection from abdominal maternal ECG","volume":"35","author":"Varanini","year":"2014","journal-title":"Physiol. Meas."},{"key":"pmeaae98e1bib40","first-page":"50","type":"other","article-title":"The characteristic wave intervals of exercise ECG influenced by changing of heart rate","volume":"16","author":"Ye","year":"1999"}],"container-title":["Physiological Measurement"],"original-title":[],"link":[{"URL":"https:\/\/iopscience.iop.org\/article\/10.1088\/1361-6579\/ae98e1","content-type":"text\/html","content-version":"am","intended-application":"text-mining"},{"URL":"https:\/\/iopscience.iop.org\/article\/10.1088\/1361-6579\/ae98e1\/pdf","content-type":"application\/pdf","content-version":"am","intended-application":"text-mining"},{"URL":"https:\/\/iopscience.iop.org\/article\/10.1088\/1361-6579\/ae98e1","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/iopscience.iop.org\/article\/10.1088\/1361-6579\/ae98e1\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/iopscience.iop.org\/article\/10.1088\/1361-6579\/ae98e1\/pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/iopscience.iop.org\/article\/10.1088\/1361-6579\/ae98e1\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/iopscience.iop.org\/article\/10.1088\/1361-6579\/ae98e1\/pdf","content-type":"application\/pdf","content-version":"am","intended-application":"similarity-checking"},{"URL":"https:\/\/iopscience.iop.org\/article\/10.1088\/1361-6579\/ae98e1\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T10:48:06Z","timestamp":1788259686000},"score":1,"resource":{"primary":{"URL":"https:\/\/iopscience.iop.org\/article\/10.1088\/1361-6579\/ae98e1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,31]]},"references-count":40,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,9,1]]},"published-print":{"date-parts":[[2026,8,31]]}},"URL":"https:\/\/doi.org\/10.1088\/1361-6579\/ae98e1","relation":{},"ISSN":["0967-3334","1361-6579"],"issn-type":[{"value":"0967-3334","type":"print"},{"value":"1361-6579","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,31]]},"assertion":[{"value":"Synthesis of multi-channel fetal ECG using generative modeling","name":"article_title","label":"Article Title"},{"value":"Physiological Measurement","name":"journal_title","label":"Journal Title"},{"value":"paper","name":"article_type","label":"Article Type"},{"value":"\u00a9 2026 The Author(s). Published on behalf of Institute of Physics and Engineering in Medicine by IOP Publishing Ltd","name":"copyright_information","label":"Copyright Information"},{"value":"2026-04-02","name":"date_received","label":"Date Received","group":{"name":"publication_dates","label":"Publication dates"}},{"value":"2026-08-12","name":"date_accepted","label":"Date Accepted","group":{"name":"publication_dates","label":"Publication dates"}},{"value":"2026-09-01","name":"date_epub","label":"Online publication date","group":{"name":"publication_dates","label":"Publication dates"}}]}}