{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T05:01:22Z","timestamp":1791262882057,"version":"4.1.0"},"reference-count":26,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2015,9,23]],"date-time":"2015-09-23T00:00:00Z","timestamp":1442966400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Cure Onlus non-profit foundation"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2016,11]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Phase rectified signal averaging (<jats:styled-content style=\"fixed-case\">PRSA<\/jats:styled-content>) is a new method of fetal heart rate variability (<jats:styled-content style=\"fixed-case\">fHRV<\/jats:styled-content>) analysis that quantifies the average acceleration (<jats:styled-content style=\"fixed-case\">AC<\/jats:styled-content>) and deceleration capacity (<jats:styled-content style=\"fixed-case\">DC<\/jats:styled-content>) of the heart. The aim of this study was to evaluate <jats:styled-content style=\"fixed-case\">AC<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">DC<\/jats:styled-content> of <jats:styled-content style=\"fixed-case\">fHR<\/jats:styled-content> [recorded by trans\u2010abdominal fetal electrocardiogram (ta\u2010<jats:styled-content style=\"fixed-case\">fECG<\/jats:styled-content>)] in relation to Doppler velocimetry characteristics of intrauterine growth restriction (IUGR).<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Prospective case\u2013control study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Single third referral centre.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">IUGR<\/jats:styled-content> (<jats:italic>n<\/jats:italic>\u00a0=\u00a066) between 25 and 40 gestational weeks and uncomplicated pregnancies (<jats:italic>n<\/jats:italic>\u00a0=\u00a079).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In <jats:styled-content style=\"fixed-case\">IUGR<\/jats:styled-content> the nearest ta\u2010<jats:styled-content style=\"fixed-case\">fECG<\/jats:styled-content> monitoring to delivery was used for <jats:styled-content style=\"fixed-case\">PRSA<\/jats:styled-content> analysis and Doppler velocimetry parameters obtained within 48\u00a0hours. <jats:styled-content style=\"fixed-case\">AC<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">DC<\/jats:styled-content> were computed at <jats:italic>s<\/jats:italic>\u00a0=\u00a0<jats:italic>T<\/jats:italic>\u00a0=\u00a09. The relation was evaluated between either <jats:styled-content style=\"fixed-case\">AC<\/jats:styled-content> or <jats:styled-content style=\"fixed-case\">DC<\/jats:styled-content> and Doppler velocimetry parameters adjusting for gestational age at monitoring, as well as the association between either <jats:styled-content style=\"fixed-case\">AC<\/jats:styled-content> or <jats:styled-content style=\"fixed-case\">DC<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">IUGR<\/jats:styled-content> with or without brain sparing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In <jats:styled-content style=\"fixed-case\">IUGR<\/jats:styled-content>s there was a significant association between either <jats:styled-content style=\"fixed-case\">AC<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">DC<\/jats:styled-content> and middle cerebral artery pulsatility index (<jats:styled-content style=\"fixed-case\">PI<\/jats:styled-content>;<jats:italic> P<\/jats:italic>\u00a0=\u00a00.01; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.005), but the same was not true for uterine or umbilical artery <jats:styled-content style=\"fixed-case\">PI<\/jats:styled-content> (<jats:italic>P\u00a0<\/jats:italic>&gt;\u00a00.05). Both <jats:styled-content style=\"fixed-case\">IUGR<\/jats:styled-content> fetuses with and without brain sparing had lower <jats:styled-content style=\"fixed-case\">AC<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">DC<\/jats:styled-content> than controls, but this association was stronger for <jats:styled-content style=\"fixed-case\">IUGR<\/jats:styled-content>s with brain sparing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our study observed for the first time that <jats:styled-content style=\"fixed-case\">AC<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">DC<\/jats:styled-content> at <jats:styled-content style=\"fixed-case\">PRSA<\/jats:styled-content> analysis are associated with middle cerebral artery <jats:styled-content style=\"fixed-case\">PI<\/jats:styled-content>, but not with uterine or umbilical artery <jats:styled-content style=\"fixed-case\">PI<\/jats:styled-content>, and that there is a significant decrease of <jats:styled-content style=\"fixed-case\">AC<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">DC<\/jats:styled-content> in association with brain sparing in <jats:styled-content style=\"fixed-case\">IUGR<\/jats:styled-content> fetuses from 25\u00a0weeks of gestation to term.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>Brain sparing in <jats:styled-content style=\"fixed-case\">IUGR<\/jats:styled-content> fetuses is associated with decreased acceleration and deceleration capacities of the heart.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.13607","type":"journal-article","created":{"date-parts":[[2015,9,23]],"date-time":"2015-09-23T08:15:16Z","timestamp":1442996116000},"page":"1947-1954","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":51,"title":["Brain sparing effect in growth\u2010restricted fetuses is associated with decreased cardiac acceleration and deceleration capacities: a case\u2013control study"],"prefix":"10.1111","volume":"123","author":[{"given":"T","family":"Stampalija","sequence":"first","affiliation":[{"name":"Unit of Ultrasound and Prenatal Diagnosis Institute for Maternal and Child Health IRCCS Burlo Garofolo Trieste Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D","family":"Casati","sequence":"additional","affiliation":[{"name":"Department of Woman, Mother and Neonate Buzzi Children's Hospital Biomedical and Clinical Sciences School of Medicine University of Milan Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L","family":"Monasta","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology and Public Health Research Unit Institute for Maternal and Child Health IRCCS Burlo Garofolo Trieste Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R","family":"Sassi","sequence":"additional","affiliation":[{"name":"Department 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