Influence of gestational diabetes on fetal autonomic nervous system: a study using phase‐rectified signal‐averaging analysis

Lobmaier, Silvia M.; Ortiz, JU; Sewald, M.; Müller, Alexander; Schmidt, Georg; Haller, Bernhard; Oberhoffer, Renate; Schneider, K. T. M.; Giussani, Dino A.; Wacker-Gußmann, Annette

doi:10.1002/uog.18823

Cited by 16 publications

(13 citation statements)

References 45 publications

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“…The result furtherly proved the potentially significant effect hyperglycemia has on the vascular wall, even over a short duration in pregnancy. The hyperglycemia state not only affect maternal hemodynamics during pregnancy, but also affect the developing cardiovascular system and autonomic nervous system in the fetus [21,22]. The predictive value of maternal RHR we found in the current study is similar with the finding of Sirico et al [8], whose research found that early pregnancy fetal heart rate could be an independently correlated to the risk of developing GDM and a threshold of 162 bpm has high detection rate for GDM.…”

Section: Discussionsupporting

confidence: 90%

Early-pregnancy maternal heart rate is related to gestational diabetes mellitus (GDM)

Chen

Wang

Zhu

2022

European Journal of Obstetrics & Gynecology and Reproductiv

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Objective: The study examined the association between resting heart rate (RHR) of early pregnancy and risk of gestational diabetes mellitus (GDM) in Chinese population. Methods: As retrospective study, medical data of 15,092 pregnant women gave birth in 2019 was collected and analyzed. The pregnant women's age, educational level, pre-pregnancy body weight, height, parity, family history of diabetes, lipid profile, blood pressure and RHR were recorded during 11 13 +6 weeks. Multivariate logistic regression analysis was used to estimate the association between maternal characteristics and RHR and GDM. And we further evaluated the predictive roll of RHR in different sub-groups defined by their body mass index (BMI), age, fasting plasma glucose (FPG), total cholesterol and triglyceride. Results: 2313 women (15.33%) were diagnosed as GDM according to 75 g OGTT. According to the quartile value of RHR, the subjects were divided into four groups. Risk of GDM increased significantly as RHR increased. In the fully adjusted model, ORs(95%CI) for the lowest vs highest quartiles of heart rate were 1(as reference), 1.14(0.97 1.33), 1.25(1.05 1.40), 1.41(1.21 1.62), respectively. In the subgroup's analysis, we found the relationship between RHR and risk of GDM was evident in women with low and normal BMI; with normal fasting plasma; and normal serum lipid level. Conclusion:The current study shows early-pregnancy maternal RHR is associated with potential risk of developing GDM.

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Section: Discussionsupporting

confidence: 90%

Early-pregnancy maternal heart rate is related to gestational diabetes mellitus (GDM)

Chen

Wang

Zhu

2022

European Journal of Obstetrics & Gynecology and Reproductiv

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“…The average deceleration capacity (ADC) and acceleration capacity (AAC) of heart rate indices were established and assessed as indicators of these complex regulations reflecting the autonomic nervous system (ANS) function, in adults and the fetuses. Indeed, our study group already showed that fetal ANS is affected by maternal GDM [9].…”

Section: Introductionmentioning

confidence: 68%

The Impact of Gestational Diabetes in Pregnancy on the Cardiovascular System of Children at One Year of Age

Wacker-Gußmann

Schopen

Engelhard

et al. 2021

JCM

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Gestational diabetes mellitus (GDM) is a common complication in pregnancy. The effect of GDM on the cardiovascular system after birth is still unclear. Between August 2015 and December 2018, 205 pregnant women were included in the prospective controlled observational study. Patients with GDM were assigned to the study group (n = 99), whereas (n = 107) healthy women served as controls. Postnatal follow up of their offspring was performed at 12 months of age. All included children (n = 125) underwent a specific standardized protocol including anthropometric data, such as weight, height, body mass index (BMI), blood pressure (BP) recordings and ultrasound measurements of the abdominal aortic intima-media-thickness (IMT). Furthermore, at least 10 min 3-channel electrocardiogram recording was done to evaluate the autonomic nervous system (ANS) by phase rectified signal averaging. There were no significant differences in anthropometric data between the groups, neither in the blood pressure nor in the intima-media-thickness of the aorta abdominals. However, in the study group, significantly lower average acceleration capacity (AAC) (study group −20.10 ± 3.04 ms, control group −18.87 ± 4.00 ms, p = 0.02) was found, indicating ANS activation at one year of age. Further studies are required to determine if these results are persistent and if these findings have long-term effects.

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“…This is in contrast to control fetuses who showed a continuous rise in HRV over this time (Fehlert et al, 2017). However, another study (Lobmaier et al, 2018) showed evidence of increased autonomic activity, as measured by AC and DC in fetal heart rate on cardiotocography at rest in late gestation in fetuses of mothers with GDM compared to controls. Clearly, further studies are needed to advance understanding of autonomic maturation in the fetus developing in a GDM environment.…”

Section: Diabetes In Pregnancymentioning

confidence: 81%

Exposures influencing the developing central autonomic nervous system

Schlatterer

Plessis

2020

Birth Defects Research

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Autonomic nervous system function is critical for transition from in-utero to ex-utero life and is associated with neurodevelopmental and neuropsychiatric outcomes later in life. Adverse prenatal and neonatal conditions and exposures can impair or alter ANS development and, as a result, may also impact longterm neurodevelopmental outcomes. The objective of this article is to provide a broad overview of the impact of factors that are known to influence autonomic development during the fetal and early neonatal period, including maternal mood and stress during and after pregnancy, fetal growth restriction, congenital heart disease, toxic exposures, and preterm birth. We touch briefly on the typical development of the ANS, then delve into both in-utero and exutero maternal and fetal factors that may impact developmental trajectory of the ANS and, thus, have implications in transition and in long-term developmental outcomes. While many types of exposures and conditions have been shown to impact development of the autonomic nervous system, there is still much to be learned about the mechanisms underlying these influences. In the future, more advanced neuromonitoring tools will be required to better understand autonomic development and its influence on long-term neurodevelopmental and neuropsychological function, especially during the fetal period.

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Influence of gestational diabetes on fetal autonomic nervous system: a study using phase‐rectified signal‐averaging analysis

Cited by 16 publications

References 45 publications

Early-pregnancy maternal heart rate is related to gestational diabetes mellitus (GDM)

Early-pregnancy maternal heart rate is related to gestational diabetes mellitus (GDM)

The Impact of Gestational Diabetes in Pregnancy on the Cardiovascular System of Children at One Year of Age

Exposures influencing the developing central autonomic nervous system

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