Maternal cardiac deceleration capacity: a novel insight into maternal autonomic function in pregnancies complicated by hypertensive disorders and intrauterine growth restriction

D. Casati, T. Stampalija, E. Ferrazzi, A. M. Alberti, I. Scebba, A. Paganelli, D. Di Martino, M. L. Muggiasca, A. Bauer

Research output: Contribution to journalArticlepeer-review

Abstract

Objective To explore maternal cardiac deceleration capacity (DC), a marker of autonomic function derived from electrocardiographic (ECG) signals, in pregnancies complicated by intrauterine growth restriction (IUGR) and hypertensive disorders of pregnancy (HDP) associated to IUGR (HDP-IUGR) or to appropriate for gestational age fetal growth (HDP-AGAf). Methods Prospective single center case-control study conducted at Buzzi Children's Hospital, Milan. Maternal ECGs were analyzed by Phase Rectified Signal Averaging (PRSA) method to obtain cardiac DC in women with: HDP-IUGR, HDP-AGAf, severe-IUGR, mild-IUGR and uncomplicated pregnancies. IUGR was defined as abdominal circumference <5th centile; severe-IUGR was associated with umbilical artery Doppler pulsatility index >2 standard deviations. Non-parametric tests were adopted. Results 269 women were recruited. Women with HDP-IUGR (n = 35) showed significantly higher cardiac DC compared both to controls (n = 141) (p = 0.003) and women with HDP-AGAf (n = 18) (p = 0.01). Women with severe-IUGR (n = 14) showed significantly higher DC than controls (p = 0.01). Women with mild-IUGR (n = 61) as well as women with HDP-AGAf showed no differences in DC compared to controls (both p = 0.3). Conclusions Women with pregnancy complicated by severe placental failure, such as HDP-IUGR and severe IUGR, show significant autonomic alterations, as indicated by elevated cardiac DC. On the contrary, pregnancy complications such as HDP-AGAf and mild IUGR show no impact on maternal autonomic balance. We present a new approach to explore maternal autonomic cardiovascular regulation that might reflect the severity of placental vascular insufficiency.

Original languageEnglish
Pages (from-to)6-11
Number of pages6
JournalEuropean Journal of Obstetrics, Gynecology and Reproductive Biology
Volume206
DOIs
Publication statusPublished - Nov 1 2016

Keywords

  • Cardiac deceleration capacity
  • Hypertensive disorders of pregnancy
  • Intrauterine growth restriction
  • Maternal autonomic function

ASJC Scopus subject areas

  • Medicine(all)
  • Reproductive Medicine
  • Obstetrics and Gynaecology

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