Byfield Renée, Yang Irene, Higgins Melinda, Carlson Nicole
Emory University, Atlanta, GA, USA.
Biol Res Nurs. 2025 Jul;27(3):487-503. doi: 10.1177/10998004251325212. Epub 2025 Mar 24.
Maternal mental health conditions significantly contribute to pregnancy-related mortality in the United States. Approximately 20-25% of postnatal women exhibit symptoms of depressive and anxiety disorders. Mental health is influenced by stress, which affects mood, cognition, and behavior. Heart rate variability (HRV), the time interval between consecutive heartbeats, is a physiological marker for assessing stress levels, providing critical insights into the body's autonomic responses. Wearable devices measuring HRV offer a non-invasive method to monitor stress and mental health, enabling early detection of maternal stress dynamics to facilitate timely interventions. In this scoping review, we aimed to capture the current state of science on two areas of focus: (1) utilization of wearable technology for HRV monitoring in pregnant and postpartum women, (2) findings from these perinatal HRV studies, including observed HRV trends throughout pregnancy and postpartum, as well as the association between HRV, perinatal stress, and mental health. The six included perinatal HRV studies employed five fitness tracking wearables, utilizing either periodic or continuous 24-h monitoring. Findings include evidence that HRV declines during pregnancy, with a return to normal levels postpartum. Associations between HRV and stress were inconsistent across studies, with some demonstrating correlations and others reporting no relationship. Postpartum HRV measurements effectively differentiated between women with postpartum depression (PPD) versus those with adjustment disorder (AJD), demonstrating high diagnostic accuracy. In this scoping review, HRV shows promise as a stress biomarker among pregnant/postpartum people, although more work is needed to standardize optimal methods of wearable HRV measurement in this population.
在美国，孕产妇心理健康状况是导致与妊娠相关死亡的重要因素。约20%-25%的产后女性表现出抑郁和焦虑障碍症状。心理健康受压力影响，压力会影响情绪、认知和行为。心率变异性（HRV）是连续心跳之间的时间间隔，是评估压力水平的生理指标，能为身体的自主反应提供关键见解。测量HRV的可穿戴设备提供了一种非侵入性方法来监测压力和心理健康，能够早期发现孕产妇压力动态变化以便及时干预。在本综述中，我们旨在了解两个重点领域的当前科学状况：（1）可穿戴技术在孕妇和产后女性HRV监测中的应用；（2）这些围产期HRV研究的结果，包括整个孕期和产后观察到的HRV趋势，以及HRV、围产期压力和心理健康之间的关联。纳入的六项围产期HRV研究使用了五种健身追踪可穿戴设备，采用定期或连续24小时监测。研究结果包括：有证据表明孕期HRV下降，产后恢复到正常水平。不同研究中HRV与压力之间的关联并不一致，有些显示出相关性，而有些则报告无关联。产后HRV测量能够有效区分产后抑郁症（PPD）女性和适应障碍（AJD）女性，显示出较高的诊断准确性。在本综述中，HRV有望成为孕妇/产后人群的压力生物标志物，不过仍需要开展更多工作来规范该人群中可穿戴HRV测量的最佳方法。
