Maser Raelene E, Lenhard M James, Kolm Paul
Department of Medical Laboratory Sciences, University of Delaware, Newark, DE, USA; Diabetes and Metabolic Research Center, Christiana Care Health System, Newark, DE, USA.
Diabetes and Metabolic Research Center, Christiana Care Health System, Newark, DE, USA; Diabetes and Metabolic Diseases Center, Christiana Care Health System, Wilmington, DE, USA.
J Diabetes Complications. 2014 Sep-Oct;28(5):684-8. doi: 10.1016/j.jdiacomp.2014.05.005. Epub 2014 May 22.
The aim of this study was to evaluate the influence of gestational diabetes mellitus (GDM) and positional aortocaval compression on cardiovascular autonomic nervous system (ANS) function in late pregnancy.
Pregnant women with (n=31) and without (n=12) GDM were evaluated at 30-35weeks gestation and 2-3months postpartum. Measures of ANS function included power spectral analysis (performed sitting) and RR-variation during deep breathing (performed supine). Time-related changes (late pregnancy versus 2-3months postpartum) for measurements of cardiovascular ANS function were analyzed using multivariate analysis of variance for repeated measures.
Baseline characteristics were similar for both groups. Comparing ANS measures for GDM+versus GDM- women during pregnancy and postpartum revealed no significant differences. Time related changes indicated that during late pregnancy total spectral power, low frequency (LF) power, high frequency (HF) power, and RR-variation during deep breathing were significantly reduced (p<0.001 for all). The LF/HF ratio, however, was not significantly affected during late pregnancy (p=0.678).
Our results suggest decreased activity in both branches of the ANS during mid-third trimester pregnancy, but no significant change in sympathovagal balance. Aortocaval compression appears to affect ANS function whether tests were performed sitting or supine for GDM+and GDM- women.
本研究旨在评估妊娠期糖尿病（GDM）和体位性主动脉腔静脉压迫对妊娠晚期心血管自主神经系统（ANS）功能的影响。
对患有（n = 31）和未患有（n = 12）GDM的孕妇在妊娠30 - 35周及产后2 - 3个月进行评估。ANS功能的测量包括功率谱分析（坐姿进行）和深呼吸时的RR变异（仰卧位进行）。使用重复测量的多变量方差分析来分析心血管ANS功能测量的时间相关变化（妊娠晚期与产后2 - 3个月）。
两组的基线特征相似。比较妊娠期间和产后GDM +组与GDM -组的ANS测量值，未发现显著差异。时间相关变化表明，妊娠晚期总频谱功率、低频（LF）功率、高频（HF）功率以及深呼吸时的RR变异均显著降低（所有p < 0.001）。然而，妊娠晚期LF/HF比值未受到显著影响（p = 0.678）。
我们的结果表明，妊娠晚期ANS的两个分支活动均降低，但交感迷走神经平衡无显著变化。对于GDM +和GDM -的女性，无论测试是坐姿还是仰卧位进行，主动脉腔静脉压迫似乎都会影响ANS功能。
