Comprehensive Physiology Wiley Online Library

Control of Breathing in the Fetus and the Newborn

Full Article on Wiley Online Library



Abstract

The sections in this article are:

1 Fetus
1.1 Methods of Studying Fetal Respiratory Activity
1.2 Normal Patterns of Fetal Respiratory Activity
1.3 Respiratory Afferent Input in Fetus
1.4 Respiratory Responses to Chemical Stimuli
1.5 Respiratory Responses to Somatic Stimulation
1.6 Miscellaneous Chemical Substances and Fetal Breathing
1.7 Patterns of Fetal Breathing During Labor
1.8 Fetal Breathing and Maternal Plasma Glucose Levels
1.9 Clinical Application of Fetal Breathing Movements
1.10 Conclusion
2 Newborn
2.1 Introduction
2.2 Chemoreceptors
2.3 Stretch Receptors
2.4 Irritant Receptors
2.5 Other Neural Inputs
2.6 Normal Breathing
Figure 1. Figure 1.

Recorder tracings from late gestational in utero fetal lamb showing relationship between diaphragmatic contractions and both tracheal pressure (Pt) and tracheal flow (Qt). Although flow amplitude is considerable, movements of flow occur over small time intervals and thus the volume of lung liquid moved in and out of the trachea with each contraction is small. Pca, carotid artery pressure.

From Maloney et al. 158
Figure 2. Figure 2.

Recorder tracings from in utero fetal lamb at 142 days gestation. Records from top to bottom show biparietal electrocorticogram (ECoG), tracheal pressure, tracheal flow, and tracheal flow integrated over 5‐min intervals (tracheal volume). Note episodic nature of fetal breathing movements and association of low‐voltage ECoG activity with presence of fetal respiratory activity.

From Dawes 65
Figure 3. Figure 3.

Analysis of diaphragmatic electromyogram (EMG) activity from a fetus at 5 different gestational ages and as a newborn. Rate of respiratory activity is shown on ordinate for each minute of 2‐h recording period (newborn record only 105‐min duration). Gestational age (days) is displayed on each graph, as is postdelivery time (h) for newborn. Note increasing duration of periods of diaphragmatic quiescence as gestation proceeds and significant change in respiratory pattern after delivery.

From Bowes et al. 32
Figure 4. Figure 4.

Motion of rib cage and abdomen and electrical activity of respiratory muscles in quiet and rapid‐eye‐movement (REM) sleep in preterm infant. In REM sleep there is paradoxical motion of rib cage, increase in abdominal excursion, decrease in intercostal electromyogram (EMG), and substantial increase in diaphragmatic EMG.

Figure 5. Figure 5.

Running cross‐covariance between tidal volume (Vt) and frequency (f) in infant in rapid‐eye‐movement (REM) and non‐rapid‐eye‐movement (NREM) sleep. Each line is cross covariance over 50‐s period and subsequent lines repeated 1–2 s later. In NREM sleep there is consistent negative deflection at zero lag; i.e., Vt and f are consistently out of phase. In REM sleep, amplitude of cross covariance and lag are much more variable and inconsistently negative at zero lag.

From Hathorn 113


Figure 1.

Recorder tracings from late gestational in utero fetal lamb showing relationship between diaphragmatic contractions and both tracheal pressure (Pt) and tracheal flow (Qt). Although flow amplitude is considerable, movements of flow occur over small time intervals and thus the volume of lung liquid moved in and out of the trachea with each contraction is small. Pca, carotid artery pressure.

From Maloney et al. 158


Figure 2.

Recorder tracings from in utero fetal lamb at 142 days gestation. Records from top to bottom show biparietal electrocorticogram (ECoG), tracheal pressure, tracheal flow, and tracheal flow integrated over 5‐min intervals (tracheal volume). Note episodic nature of fetal breathing movements and association of low‐voltage ECoG activity with presence of fetal respiratory activity.

From Dawes 65


Figure 3.

Analysis of diaphragmatic electromyogram (EMG) activity from a fetus at 5 different gestational ages and as a newborn. Rate of respiratory activity is shown on ordinate for each minute of 2‐h recording period (newborn record only 105‐min duration). Gestational age (days) is displayed on each graph, as is postdelivery time (h) for newborn. Note increasing duration of periods of diaphragmatic quiescence as gestation proceeds and significant change in respiratory pattern after delivery.

From Bowes et al. 32


Figure 4.

Motion of rib cage and abdomen and electrical activity of respiratory muscles in quiet and rapid‐eye‐movement (REM) sleep in preterm infant. In REM sleep there is paradoxical motion of rib cage, increase in abdominal excursion, decrease in intercostal electromyogram (EMG), and substantial increase in diaphragmatic EMG.



Figure 5.

Running cross‐covariance between tidal volume (Vt) and frequency (f) in infant in rapid‐eye‐movement (REM) and non‐rapid‐eye‐movement (NREM) sleep. Each line is cross covariance over 50‐s period and subsequent lines repeated 1–2 s later. In NREM sleep there is consistent negative deflection at zero lag; i.e., Vt and f are consistently out of phase. In REM sleep, amplitude of cross covariance and lag are much more variable and inconsistently negative at zero lag.

From Hathorn 113
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A. Charles Bryan, Glenn Bowes, John E. Maloney. Control of Breathing in the Fetus and the Newborn. Compr Physiol 2011, Supplement 11: Handbook of Physiology, The Respiratory System, Control of Breathing: 621-647. First published in print 1986. doi: 10.1002/cphy.cp030218