Instituto de Maternidad Nuestra Señora de las Mercedes - Sistema Provincial de Salud (SIPROSA), Tucumán, Argentina.
Departamento Biomédico, Instituto de Fisiología, Facultad de Medicina - UNT, INSIBO - CONICET, Tucumán, Argentina.
J Obstet Gynaecol. 2022 May;42(4):607-613. doi: 10.1080/01443615.2021.1945003. Epub 2021 Aug 11.
This study aimed to evaluate vascular function changes and autonomic balance during the first trimester of pregnancy and its relationship with the new-born weight. This prospective study performed in pregnant (PG) women and after delivery (not pregnant: NPG) evaluated the endothelial function (EF) and arterial stiffness (AS) by a non-invasive method. We evaluated the heart rate variability (HRV), parasympathetic nervous system (PNS), sympathetic nervous system (SNS) indexes by electrocardiogram (5 min) and the urinary nitrite excretion (NOx). PG increased EF and NOx and decreased AS and HRV. PG decreased the PNS index and augmented the SNS index. The new-born weight positively correlated with the PNS index (Pearson's : 0.4291; <.05), NOx, HRV and negatively correlated with AS. In summary, in pregnancy, although haemodynamically, the SNS activation plays a compensatory role, the low rates of PNS inhibition are essential to ensure normal foetal growth.Impact Statement In pregnancy, there are adaptive physiological changes in the cardiovascular system that include increases of EF and decreases AS with an SNS activation. The study of HRV lets to predict the SNS and PNS balance and how they affect blood pressure and vascular function. Although it is known that SNS activation plays a compensatory role in healthy pregnancy, this study adds the critical role of PNS. Early in pregnancy, the low rates of PNS inhibition are essential to ensure normal foetal growth. The present results show a potential predictive value of SNS and PNS activity early in pregnancy. It will provide valuable information not only on the pregnant woman's vascular function but also on the new-born weight.
本研究旨在评估妊娠早期血管功能变化和自主平衡及其与新生儿体重的关系。这项前瞻性研究在孕妇（PG）和产后（非孕妇：NPG）中进行，通过非侵入性方法评估内皮功能（EF）和动脉僵硬（AS）。我们通过心电图（5 分钟）评估心率变异性（HRV）、副交感神经系统（PNS）、交感神经系统（SNS）指数，并评估尿亚硝酸盐排泄（NOx）。PG 增加了 EF 和 NOx，降低了 AS 和 HRV。PG 降低了 PNS 指数并增加了 SNS 指数。新生儿体重与 PNS 指数（Pearson 相关系数：0.4291；<0.05）、NOx、HRV 呈正相关，与 AS 呈负相关。总之，在妊娠期间，尽管血液动力学上 SNS 激活发挥了代偿作用，但 PNS 抑制率低对于确保正常胎儿生长至关重要。
在妊娠期间，心血管系统会发生适应性生理变化，包括 EF 增加和 AS 降低以及 SNS 激活。HRV 的研究可以预测 SNS 和 PNS 的平衡，以及它们如何影响血压和血管功能。尽管众所周知，SNS 激活在健康妊娠中发挥代偿作用，但本研究增加了 PNS 的关键作用。在妊娠早期，PNS 抑制率低对于确保正常胎儿生长至关重要。本研究结果显示了 SNS 和 PNS 活性在妊娠早期的潜在预测价值。它不仅提供了孕妇血管功能的有价值信息，还提供了新生儿体重的信息。
