{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T22:09:33Z","timestamp":1775167773313,"version":"3.50.1"},"reference-count":31,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2017,9,27]],"date-time":"2017-09-27T00:00:00Z","timestamp":1506470400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000317","name":"Action Medical Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000317","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000852","name":"Henry Smith Charity","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000852","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000061","name":"Fogarty International Center","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000061","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["1R21HD084114\u201001"],"award-info":[{"award-number":["1R21HD084114\u201001"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2017,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>One indicator for fetal risk of mortality is intrauterine growth restriction (<jats:styled-content style=\"fixed-case\">IUGR<\/jats:styled-content>). Whether markers reflecting the impact of growth restriction on the cardiovascular system, computed from a Doppler\u2010derived heart rate signal, would be suitable for its detection antenatally was studied.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>We used a cardiotocography archive of 1163 <jats:styled-content style=\"fixed-case\">IUGR<\/jats:styled-content> cases and 1163 healthy controls, matched for gestation and gender. We assessed the discriminative power of short\u2010term variability and long\u2010term variability of the fetal heart rate, computed over episodes of high and low variation aiming to separate growth\u2010restricted fetuses from controls. Metrics characterizing the sleep state distribution within a trace were also considered for inclusion into an <jats:styled-content style=\"fixed-case\">IUGR<\/jats:styled-content> detection model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Significant differences in the risk markers comparing growth\u2010restricted with healthy fetuses were found. When used in a logistic regression classifier, their performance for identifying <jats:styled-content style=\"fixed-case\">IUGR<\/jats:styled-content> was considerably superior before 34\u00a0weeks of gestation. Long\u2010term variability in active sleep was superior to short\u2010term variability [area under the receiver operator curve (<jats:styled-content style=\"fixed-case\">AUC<\/jats:styled-content>) of 72% compared with 71%]. Most predictive was the number of minutes in high variation per hour (<jats:styled-content style=\"fixed-case\">AUC<\/jats:styled-content> of 75%). A multivariate <jats:styled-content style=\"fixed-case\">IUGR<\/jats:styled-content> prediction model improved the <jats:styled-content style=\"fixed-case\">AUC<\/jats:styled-content> to 76%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We suggest that heart rate variability markers together with surrogate information on sleep states can contribute to the detection of early\u2010onset <jats:styled-content style=\"fixed-case\">IUGR<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.13228","type":"journal-article","created":{"date-parts":[[2017,9,1]],"date-time":"2017-09-01T14:44:39Z","timestamp":1504277079000},"page":"1322-1329","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Doppler\u2010based fetal heart rate analysis markers for the detection of early intrauterine growth restriction"],"prefix":"10.1111","volume":"96","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4724-1456","authenticated-orcid":false,"given":"Lisa","family":"Stroux","sequence":"first","affiliation":[{"name":"Institute of Biomedical Engineering Department of Ethics approval to use this database was givenEngineering Science University of Oxford Oxford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher W.","family":"Redman","sequence":"additional","affiliation":[{"name":"Nuffield Department of Obstetrics &amp; Gynecology University of Oxford Oxford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5543-6683","authenticated-orcid":false,"given":"Antoniya","family":"Georgieva","sequence":"additional","affiliation":[{"name":"Nuffield Department of Obstetrics &amp; Gynecology University of Oxford Oxford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen 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