Sharifi-Heris Zahra, Rahmani Amir M, Axelin Anna, Rasouli Mahkameh, Bender Miriam
University of California Irvine, Irvine, CA, United States.
University of Turku, Turku, Finland.
Interact J Med Res. 2023 Jun 5;12:e44430. doi: 10.2196/44430.
The autonomic nervous system (ANS) is known as a critical regulatory system for pregnancy-induced adaptations. If it fails to function, life-threatening pregnancy complications could occur. Hence, understanding and monitoring the underlying mechanism of action for these complications are necessary.
We aimed to systematically review the literature concerned with the associations between heart rate variability (HRV), as an ANS biomarker, and pregnancy complications.
We performed a comprehensive search in the PubMed, Medline Completion, CINAHL Completion, Web of Science Core Collection Classic, Cochrane Library, and SCOPUS databases in February 2022 with no time span limitation. We included studies concerned with the association between any pregnancy complications and HRV, with or without a control group. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guideline was used for the review of the studies, and Covidence software was used for the study selection process. For data synthesis, we used the guideline by Popay et al.
Finally, 12 studies with 6656 participants were included. Despite the methodological divergency that hindered a comprehensive comparison, our findings suggest that ANS is linked with some common pregnancy complications including fetal growth. However, existing studies do not support an association between ANS and gestational diabetes mellitus. Studies that linked pulmonary and central nervous system disorders with ANS function did not provide enough evidence to draw conclusions.
This review highlights the importance of understanding and monitoring the underlying mechanism of ANS in pregnancy-induced adaptations and the need for further research with robust methodology in this area.
自主神经系统（ANS）是孕期适应性变化的关键调节系统。若其功能失调，可能会出现危及生命的妊娠并发症。因此，了解和监测这些并发症的潜在作用机制很有必要。
我们旨在系统回顾有关心率变异性（HRV）作为自主神经系统生物标志物与妊娠并发症之间关联的文献。
2022年2月，我们在PubMed、Medline Completion、CINAHL Completion、Web of Science核心合集经典版、Cochrane图书馆和SCOPUS数据库中进行了全面检索，无时间跨度限制。我们纳入了有关任何妊娠并发症与HRV之间关联的研究，无论是否设有对照组。采用PRISMA（系统评价和Meta分析的首选报告项目）指南对研究进行综述，并使用Covidence软件进行研究筛选。对于数据合成，我们采用了Popay等人的指南。
最终纳入了12项研究，共6656名参与者。尽管方法上的差异阻碍了全面比较，但我们的研究结果表明，自主神经系统与包括胎儿生长在内的一些常见妊娠并发症有关。然而，现有研究不支持自主神经系统与妊娠期糖尿病之间存在关联。将肺部和中枢神经系统疾病与自主神经系统功能联系起来的研究没有提供足够的证据来得出结论。
本综述强调了了解和监测自主神经系统在孕期适应性变化中潜在机制的重要性，以及在该领域采用更完善方法进行进一步研究的必要性。
