A Point Process Framework for the Characterization of Fetal Sleep States

In the fetal period, the progressive coordination among several subsystems promotes the emergence of sleep states. For this reason, the characterization of fetal behavioral states plays a crucial role in assessing fetal wellbeing. Nevertheless, current methodologies aimed at assessing fetal sleep states over limited time intervals require visual observation of the traces. In this work, we validate a point process approach for a continuous in time characterization of fetal behavioral states. We compare traditional heart rate variability (HRV) parameters and the corresponding point process-extracted sets of time and frequency measures in a population of 39 fetuses whose fetal ECG was recorded overnight during the third trimester of gestation.Clinical Relevance— Our results provide evidence for the proposed point process framework to capture fetal HRV dynamics with a high degree of reliability, suggesting its potential application for instantaneous estimates of fetal sleep states.