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Am J Perinatol 2015; 32(11): 1050-1058
DOI: 10.1055/s-0035-1548542
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Beat-to-Beat Heart Rate and Blood Pressure Variability and Hypertensive Disease in Pregnancy

Pamela Flood
1   Department of Anesthesia, Perioperative and Pain Medicine, Stanford University, San Francisco, California
,
Paula McKinley
2   Department of Behavioral Medicine, Columbia University, New York, New York
,
Catherine Monk
3   Department of Psychiatry, Behavioral Medicine and Developmental Neuroscience, Columbia University, New York, New York
,
Paul Muntner
4   Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama
,
Lisandro D. Colantonio
4   Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama
,
Laura Goetzl
5   Department of Obstetrics and Gynecology, Temple University, Philadelphia, Pennsylvania
,
Maureen Hatch
6   National Institutes of Health/National Cancer Institute, Division of Cancer Epidemiology & Genetics, Radiation Epidemiology Branch Bethesda, Maryland
,
Richard P. Sloan
2   Department of Behavioral Medicine, Columbia University, New York, New York
› Author Affiliations
Further Information

Publication History

30 November 2014

30 January 2015

Publication Date:
13 May 2015 (online)

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Abstract

Objective The aim of this study is to determine the relationship between heart rate and/or blood pressure variability, measured at 28 weeks' gestation, and the incidence of pregnancy-induced hypertension or preeclampsia.

Study Design Secondary analysis of data from a prospectively enrolled cohort of 385 active military women in whom spectral analysis of continuous heart rate and variability was measured at 28 weeks' gestation. The primary outcome was the predictive value of spectral analysis of heart rate and blood pressure for hypertensive diseases of pregnancy.

Results High-frequency heart rate variability was reduced and low-frequency variability of systolic and diastolic blood pressure increased in women who would develop pregnancy-induced hypertension but not preeclampsia. Low-frequency variability of diastolic blood pressure remained a significant predictor of pregnancy-induced hypertension but not preeclampsia after adjustment for age, weight, and blood pressure in a multivariate model.

Conclusion Early identification of pregnancy-induced hypertension can facilitate treatment to avoid maternal morbidity. Understanding the physiological underpinnings of the two very different diseases may lead to improved treatment and prevention. If proven effective in a broader population, the ability to differentiate pregnancy-induced hypertension from preeclampsia may reduce unnecessary iatrogenic interventions or inappropriate preterm delivery.

Keywords

hypertensive diseases of pregnancy - autonomic function - heart rate variability - blood pressure variability

Note

The cohort was assembled at Lackland Air force Base, San Antonio, TX when Dr. Hatch was a faculty member at Mt. Sinai Hospital, New York, NY. Reprints will not be available


Comment to this article:

Beat-to-Beat Heart Rate and Blood Pressure Variability and Hypertensive Disease in Pregnancy (Podcast)Am J Perinatol 2015; 32(11): e2-e2
DOI: 10.1055/s-0035-1566729

 

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