Bester M, Joshi R, Mischi M, van Laar Joeh, Vullings R
Department of Electrical Engineering, Eindhoven University of Technology, 5612 AZ, Eindhoven, The Netherlands.
Patient Care and Monitoring, Philips Research, 5656 AE, Eindhoven, The Netherlands.
Physiol Meas. 2023 May 10;44(5). doi: 10.1088/1361-6579/acce1e.
. Appropriate adaptation of the maternal autonomic nervous system to progressing gestation is essential to a healthy pregnancy. This is partly evidenced by the association between pregnancy complications and autonomic dysfunction. Therefore, assessing maternal heart rate variability (HRV)-a proxy measure for autonomic activity-may offer insights into maternal health, potentially enabling the early detection of complications. However, identifying abnormal maternal HRV requires a thorough understanding of normal maternal HRV. While HRV in women of childbearing age has been extensively investigated, less is known concerning HRV during pregnancy. Subsequently, we investigate the differences in HRV between healthy pregnant women and their non-pregnant counterparts.. We use a comprehensive suite of HRV features (assessing sympathetic and parasympathetic activity, heart rate (HR) complexity, HR fragmentation, and autonomic responsiveness) to quantify HRV in large groups of healthy pregnant (= 258) and non-pregnant women (= 252). We compare the statistical significance and effect size of the potential differences between the groups.. We find significantly increased sympathetic and decreased parasympathetic activity during healthy pregnancy, along with significantly attenuated autonomic responsiveness, which we hypothesize serves as a protective mechanism against sympathetic overactivity. HRV differences between these groups typically had a large effect size (Cohen's> 0.8), with the largest effect accompanying the significantly reduced HR complexity and altered sympathovagal balance observed in pregnancy (Cohen's> 1.2).. Healthy pregnant women are autonomically distinct from their non-pregnant counterparts. Subsequently, assumptions based on HRV research in non-pregnant women cannot be readily translated to pregnant women.
孕期母体自主神经系统的适度调适对于健康妊娠至关重要。妊娠并发症与自主神经功能障碍之间的关联在一定程度上证明了这一点。因此，评估母体心率变异性（HRV）——自主神经活动的替代指标——可能有助于了解母体健康状况，有可能实现并发症的早期检测。然而，识别异常的母体HRV需要对正常的母体HRV有透彻的了解。虽然育龄女性的HRV已得到广泛研究，但关于孕期HRV的了解较少。随后，我们研究了健康孕妇与其未怀孕 counterparts之间HRV的差异。我们使用一套全面的HRV特征（评估交感神经和副交感神经活动、心率（HR）复杂性、HR碎片化和自主神经反应性）来量化大量健康孕妇（=258）和未怀孕女性（=252）的HRV。我们比较了两组之间潜在差异的统计显著性和效应大小。我们发现，在健康妊娠期间，交感神经活动显著增加，副交感神经活动减少，同时自主神经反应性显著减弱，我们推测这是一种针对交感神经活动过度的保护机制。这些组之间的HRV差异通常具有较大的效应大小（Cohen's>0.8），其中最大的效应伴随着妊娠期间观察到的HR复杂性显著降低和交感迷走平衡改变（Cohen's>1.2）。健康孕妇在自主神经方面与未怀孕的 counterparts不同。随后，基于未怀孕女性HRV研究的假设不能轻易应用于孕妇。
