Gestational diabetic patients with adequate management have normal cardiovascular autonomic regulation during the third trimester of pregnancy and 3 months after delivery |
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| Authors: | Nonna Heiskanen Heli Saarelainen Henna Kärkkäinen Pirjo Valtonen Tiina Lyyra-Laitinen Tomi Laitinen Esko Vanninen Seppo Heinonen |
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| Affiliation: | 1. Department of Cardiology, Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey;2. Department of Perinatology, Zekai Tahir Burak Women Health Care, Education and Research Hospital, Ankara, Turkey;3. Department of Cardiology, Ataturk Education and Research Hospital, Ankara, Turkey;4. Gazi University Medical School, Department of Obstetrics and Gynecology, Ankara, Turkey;1. Department of Anesthesiology, University of Occupational and Environmental Health, School of Medicine, Yahatanishiku, Kitakyushu 807-8555, Japan;2. Division of Operative Medicine, University of Occupational and Environmental Health, University Hospital, Yahatanishiku, Kitakyushu 807-8555, Japan;1. Metropolitan Autonomous University (UAM), Campus Iztapalapa, Basic Sciences and Engineering Division, Mexico City 09340, Mexico;2. UAM, Campus Lerma, Biological and Health Sciences Division, Lerma 52000, Mexico;3. Maternal and Childhood Research Center (CIMIGen), 09890 Mexico City, Mexico;4. UAM, Campus Iztapalapa, Biological and Health Sciences Division, 09340 Mexico City, Mexico;5. University of Leiden, Faculty of Social and Behavioural Sciences, Health, Medical and Neuropsychology Unit, 2333 AK Leiden, The Netherlands |
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| Abstract: | ObjectiveThe aim of the present study was to evaluate the influence of gestational diabetes mellitus (GDM) on hemodynamics and cardiovascular autonomic regulation at rest and their responses to head-up tilt (HUT).Research Design and MethodsWe prospectively studied 79 pregnant women (51 with GDM, 28 without GDM) during the third trimester of pregnancy and after parturition. The maternal electrocardiogram and arterial blood pressure were noninvasively measured. Heart rate and blood pressure were measured in the supine position and in the upright position. Stroke volume was assessed from noninvasive blood pressure signals, heart rate variability (HRV) was analyzed in frequency domain, and baroreflex sensitivity by the cross-spectral and sequence methods.ResultsBetween the GDM group and control pregnant women there were no significant differences in hemodynamics and cardiovascular autonomic regulation throughout the protocol. Increased normalized low-frequency component and low-frequency to high-frequency ratio suggested a change in sympathovagal balance towards sympathetic predominance during pregnancy in both groups. The response to head-up tilt (HUT) was similar in both GDM and control pregnant women. The pregnancy modulated the response to HUT in systolic and diastolic blood pressure, stroke volume, cardiac index, peripheral resistance, total power of HRV, and its low- and high-frequency components.ConclusionsOur results suggest that pregnancy modulates cardiovascular autonomic regulation and hemodynamics equally in subjects with GDM and without GDM, suggesting that metabolic disorder during pregnancy does not result in cardiovascular dysfunction when GDM is in good balance. |
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