Vasopressin and oxytocin levels during normal pregnancy: effects of chronic dietary sodium restriction

Post, Joris A. M. van der; Buul, Bert J. A. van; Hart, Andrew; Heerikhuize, J.J.M. van; Pesman, G. J.; Legros, J. J.; Steegers, Eric A.P.; Swaab, D.F.; Boer, Kees

doi:10.1677/joe.0.1520345

Cited by 35 publications

(14 citation statements)

References 15 publications

(28 reference statements)

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“…26 Fasting levels of insulin are raised in the 3rd trimester of pregnancy in women who later develop hypertension, 27 and hyperinsulinemia produces sympathetic activation. 28 Reduction in vasopressin levels has also been reported in pregnacy, 29 and infusion of this hormone has been shown to decrease MSNA. 30 More recently it has been shown that MSNA is greater in young women during the midluteal compared with early follicular phase of the menstrual cycle, when estradiol and progesterone are elevated, 31 and in pregnancy these hormones are additionally elevated.…”

Section: Discussionmentioning

confidence: 91%

Sympathetic Neural Mechanisms in Normal and Hypertensive Pregnancy in Humans

et al. 2001

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Background-Direct recordings from peripheral sympathetic nerves have shown an increased sympathetic drive in pregnancy-induced hypertension (PIH) and preeclampsia (PE). It is unknown whether sympathetic drive is altered in normal pregnancy, when arterial blood pressure can be normal or relatively low. The aim of this study was to measure and compare peripheral sympathetic discharge, its vasoconstrictor effect and its baroreceptor control, during pregnancy and postpartum in women with normal pregnancy (NP) and PIH and in normotensive nonpregnant (NN) women. Methods and Results-Twenty-one women with NP, 18 women with PIH, and 21 NN women had muscle sympathetic nerve activity assessed from multiunit discharges (MSNA) and from single units with defined vasoconstrictor properties (s-MSNA). The s-MSNA in NP (38Ϯ6.6 impulses/100 beats) was greater (PϽ0.05) than in NN women (19Ϯ1.8 impulses/100 beats) despite similar age and body weight but less than in PIH women (PϽ0.001) (146Ϯ23.5 impulses/100 beats). MSNA followed a similar trend. Cardiac baroreceptor reflex sensitivity (BRS) was impaired in NP and PIH women relative to NN. After delivery, sympathetic activity decreased to values similar to those obtained in NN, and there was an increase in BRS. In women with NP, the decrease in sympathetic output occurred despite an insignificant change in blood pressure. Conclusions-Central sympathetic output was increased in women with normal pregnancy and was even greater in the hypertensive pregnant group. The findings suggest that the moderate sympathetic hyperactivity during the latter months of normal pregnancy may help to return the arterial pressure to nonpregnant levels, although when the increase in activity is excessive, hypertension may ensue. (Circulation. 2001;104:2200-2204.)

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Section: Discussionmentioning

confidence: 91%

Sympathetic Neural Mechanisms in Normal and Hypertensive Pregnancy in Humans

et al. 2001

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“…Thus it would seem that in the context of a securely-attached female with low separation anxiety, oxytocin release, a key factor shown by past research in regulating the mother’s response to stress, assists in promoting positive affiliation with supportive attachment figures and in shaping optimal bonding with her infant [37]. While it is possible that breastfeeding is associated with an increase in oxytocin levels, previous research has indicated that there are no differences in oxytocin between breast-feeding and non-breast-feeding mothers when samples are not taken during actual breast-feeding [38] since oxytocin production is not pulsatile when mothers are not nursing [39].…”

Section: Discussionmentioning

confidence: 99%

Separation Anxiety, Attachment and Inter-Personal Representations: Disentangling the Role of Oxytocin in the Perinatal Period

et al. 2014

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In this paper, we aimed to assess cross-sectionally and longitudinally associations between disturbances in maternal early attachment experiences, symptoms of separation anxiety and depression and oxytocin plasma levels. We examined a mediational model that tested the hypothesis that anxious attachment style arising from the mothers’ early bonding experiences with her own parents was associated with high levels of separation anxiety which, via its impact on depression, was associated with reduced levels of oxytocin in the postnatal period. Data is reported on a structured sample of 127 women recruited during pregnancy from a general hospital antenatal clinic and an initial follow up cohort of 57 women who were re-assessed at 3-months post-partum. We found an association between lower oxytocin level in the post partum period and symptoms of separation anxiety and depression during pregnancy, as well as maternal negative interpersonal representations, upbringing attributes and anxious attachment style. Further meditational analysis revealed that the unique association between anxious attachment and depression is mediated by separation anxiety and that depressed mood mediated the relationship between separation anxiety and oxytocin. In conjunction with evidence from the literature suggesting that lower oxytocin level is associated with bonding difficulties, our findings have significant implications for understanding the biological processes underpinning adverse attachment experiences, negative affect state, and mother-to-infant bonding difficulties.

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“…Dietary sodium restriction during pregnancy has raised concerns that it would limit the volume expansion characteristic of normal pregnancy. Sodium restriction implemented after the first 12 weeks of pregnancy does not appear to be harmful in normotensive women, 52,53 but there are no data to support that sodium restriction limits the occurrence of preeclampsia. 54 ACOG recommends against the use of very low salt diets (<100 mEq/dy) to manage chronic hypertension in pregnancy.…”

Section: Lifestyle Modification For Blood Pressure Control During Prementioning

confidence: 99%

Chronic Hypertension in Pregnancy

2014

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1254C hronic hypertension in pregnancy is defined by the American College of Obstetrics and Gynecology (ACOG) as blood pressure ≥140 mm Hg systolic and/or 90 mm Hg diastolic before pregnancy or, in recognition that many women seek medical care only once pregnant, before 20 weeks of gestation, use of antihypertensive medications before pregnancy, or persistence of hypertension for >12 weeks after delivery. 1Chronic hypertension needs to be distinguished from new-onset hypertensive complications of pregnancy such as preeclampsia (elevated blood pressure and proteinuria often accompanied by evidence of maternal organ injury and fetal compromise from placental dysfunction) 2 and gestational hypertension (elevated blood pressure alone after 20 weeks of gestation and most commonly in the mid to late third trimester without evidence or history of hypertension before pregnancy; Table 1). EpidemiologyChronic hypertension is estimated to be present in ≈3% to 5% of pregnancies 1,3,4 and is increasingly more commonly encountered. Factors contributing to the increase in prevalence include 2 major risk factors for hypertension, obesity and older age, which are of increasing prevalence in pregnancy. These shifts in risk and childbearing have resulted in an increased number of women who will require counseling on the risks of chronic hypertension in pregnancy and management of their antihypertensive medications both in anticipation of and during pregnancy.5 Because many pregnancies are unplanned, 6 all women with chronic hypertension should receive regular counseling so that they can anticipate any issues that may arise if they become pregnant and optimize their health and care to temper risk. Because blacks have a higher prevalence of chronic hypertension 7 and onset occurs at younger ages, 8 it is more common to encounter chronic hypertension in blacks during pregnancy.Despite its increasing prevalence, the majority of women with chronic hypertension do well in pregnancy, but as we discuss below, some women develop complications such as superimposed preeclampsia, fetal growth restriction, placental abruption, 4,9,10 and preterm birth, and women with chronic hypertension have an increased likelihood of cesarean delivery. Physiological Changes in Blood Pressure During PregnancyWomen who are normotensive entering pregnancy typically experience a decrease in blood pressure toward the end of the first trimester. This decrease is thought to be secondary to the marked vasodilation that occurs despite the increase in plasma volume that comes with pregnancy. Blood pressure usually falls by 5 to 10 mm Hg and remains at this lower level throughout pregnancy until the third trimester, when it rises to return to prepregnancy values. For the majority of women with chronic hypertension, blood pressure changes also follow this same pattern. As a result, some hypertensive women become normotensive during pregnancy, and others who remain hypertensive can have their antihypertensive medications tapered. These physiological changes may confuse t...

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Vasopressin and oxytocin levels during normal pregnancy: effects of chronic dietary sodium restriction

Cited by 35 publications

References 15 publications

Sympathetic Neural Mechanisms in Normal and Hypertensive Pregnancy in Humans

Sympathetic Neural Mechanisms in Normal and Hypertensive Pregnancy in Humans

Separation Anxiety, Attachment and Inter-Personal Representations: Disentangling the Role of Oxytocin in the Perinatal Period

Chronic Hypertension in Pregnancy

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