Department of Obstetrics and Gynecology, Máxima Medical Center, Veldhoven, The Netherlands; Eindhoven MedTech Innovation Center (e/MTIC), Eindhoven, The Netherlands; Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.
Department of Obstetrics and Gynecology, Máxima Medical Center, Veldhoven, The Netherlands.
Pregnancy Hypertens. 2020 Apr;20:56-68. doi: 10.1016/j.preghy.2020.03.003. Epub 2020 Mar 5.
Hypertensive pregnancy disorders (HPD) are associated with dysfunction of the autonomic nervous system. Cardiac autonomic functions can be assessed by heart rate variability (HRV) measurements.
To study whether HRV detects differences in the function of the autonomic nervous system between pregnant women with HPD compared to normotensive pregnant women and between women with a history of a pregnancy complicated by HPD compared to women with a history of an uncomplicated pregnancy.
A systematic search was performed in Medline, EMBASE, and CENTRAL to identify studies comparing HRV between pregnant women with HPD or women with a history of HPD to women with (a history of) normotensive pregnancies.
The search identified 523 articles of which 24 were included in this review, including 850 women with (a history of) HPD and 1205 normotensive controls. The included studies showed a large heterogenicity. A decrease in overall HRV was found in preeclampsia (PE), compared to normotensive pregnant controls. A trend is seen towards increased low frequency/high frequency-ratio in women with PE compared to normotensive pregnant controls.
Our systematic review supports the hypothesis a sympathetic overdrive is found in HPD which is associated with a parasympathetic withdrawal. However, the included studies in our review showed a large diversity in the methods applied and their results.
妊娠高血压疾病（HPD）与自主神经系统功能障碍有关。心率变异性（HRV）测量可用于评估心脏自主功能。
研究 HPD 孕妇与正常血压孕妇、HPD 病史孕妇与无 HPD 病史孕妇之间，HRV 是否能检测到自主神经系统功能的差异。
系统检索 Medline、EMBASE 和 CENTRAL 以确定比较 HPD 孕妇或 HPD 病史孕妇与（有/无）正常血压妊娠孕妇之间 HRV 的研究。
共检索到 523 篇文章，其中 24 篇纳入本综述，包括 850 例 HPD（有/无）孕妇和 1205 例正常血压对照组。纳入的研究显示出很大的异质性。与正常血压妊娠对照组相比，子痫前期（PE）患者的整体 HRV 降低。PE 患者的低频/高频比值呈升高趋势，与正常血压妊娠对照组相比。
本系统综述支持 HPD 中存在交感神经兴奋，副交感神经抑制的假说。然而，本综述纳入的研究在方法应用及其结果方面存在很大差异。
