The effect of depression on heart rate variability during pregnancy

Abstract

Depression during pregnancy has been associated with a number of adverse outcomes, but the underlying physiological mechanisms involved remain unclear. The purpose of this study was to examine the effects of maternal depression during pregnancy on the autonomic modulation of heart rate, in a naturalistic setting. Eighty-one pregnant women were studied between 25 and 31 weeks of gestation and were identified as either Depressed (n = 46), or healthy, Control (n = 35), based on depression scores and lifetime psychiatric history. Subjects wore a 24-h Holter recorder to measure time-domain and frequency-domain of heart rate variability (HRV). Pregnant women in the Depressed Group had significantly reduced time-domain measures: standard deviation of all 24-h NN intervals (SDNN) and the standard deviation of the averages of NN intervals in all 5-min segments of the entire recording (SDANN) (P = 0.013, 0.016, respectively), as well as higher heart rates while asleep (P = 0.028), compared to Controls, after controlling for age, smoking, and antidepressant (AD) medication. The low frequency/high frequency (LF/HF) ratio during the sleeping hours was associated with higher depression scores (R = 0.24; P = 0.041). HRV measures improved in women taking AD medication. The autonomic nervous system may be affected in women experiencing depression during pregnancy, indicating a possible decreased parasympathetic (vagal) influence. Women taking AD medication showed some improvement in HRV measures. These data suggest that psychophysiological changes occur in women experiencing depression during pregnancy.

Failed Lactation and Perinatal Depression: Common Problems with Shared Neuroendocrine Mechanisms?

“…63,64 These changes appear to be attenuated in depressed pregnant women, who have higher heart rates and lower parasympathetic heart rate variability compared with nondepressed women. 65 No studies, to our knowledge, have measured sympathetic/parasympathetic balance in PPD, but major depression and anxiety are associated with reduced parasympathetic control in nonpregnant populations. 66,67 Studies linking diminished parasympathetic activity with depression and anxiety suggest that autonomic dysregulation may predispose women to mood disorders.…”

Maternal depression during pregnancy is associated with increased birth weight in term infants

“…Tonhajzerova, Visnovcova, Jurko & Mestanik (2016) point to irregularities in the neurocardiac reflex system associated with depression as the mechanism underlying this pattern. Only one study has explored cardiac measures in pregnant women as related to antenatal depression, suggesting a similar pattern of higher heart rate and lower heart rate variability (Shea, et al, 2008). Everett, Mahendru, McEnierry, Wilkinson, & Lees (2013) reported that higher maternal heart rates during the second semester of pregnancy are positively associated with higher birth weight.…”

Potential benefits of mindfulness during pregnancy on maternal autonomic nervous system function and infant development

“…A number of mental disorders have also been linked to detrimental cardiovascular changes in pregnancy. For example, maternal emotional distress or depressive symptoms are associated with abnormal cardiovascular function, such as more reduction in parasympathetic activity (Shea et al, 2008) and a larger increase in blood pressure (hypertension and preeclampsia; Kurki, Hiilesmaa, Raitasalo, Mattila, & Ylikorkala, 2000;Qiu, Sanchez, Lam, Garcia, & Williams, 2007;Qiu, Williams, Calderon-Margalit, Cripe, & Sorensen, 2009). Furthermore, both hypertension disorders (Robinson et al, 2009(Robinson et al, , 2013Whitehouse, Robinson, Newnham, & Pennell, 2012) and maternal emotional distress (R€ aikk€ onen, Seckl, Pesonen, Simons, & Van den Bergh, 2011; Van den Bergh, Mulder, Mennes, & Glover, 2005) during pregnancy are linked to adverse behavior and developmental outcomes in infancy, childhood, and adulthood.…”