A study on the assessment of cardiovascular autonomic functions among pregnant women with anemia in South India in different trimesters of pregnancy

A BSTRACT Background: Anemia during pregnancy can affect autonomic functions, crucial for maintaining cardiovascular stability. The autonomic nervous system is essential for maintaining homeostasis of the cardiovascular system. This autonomic imbalance can lead to complications such as pregnancy-induced hypertension and insufficient uteroplacental blood flow. Therefore, we planned to evaluate the cardiovascular, autonomic, and cognitive functions of South Indian pregnant women with anemia. Materials and Methods: The present analytical cross-sectional study was conducted in a tertiary care center. A total of 120 pregnant women belonging to early and late trimesters of pregnancy who visited the outpatient department of Obstetrics and Gynaecology were recruited for the study. Basal heart rate (BHR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were recorded. Heart rate variability, a complete battery of cardiac autonomic function tests, which includes lying-to-standing ratio (30:15 ratio), deep breathing ratio (E:I ratio), and diastolic blood pressure response to the isometric handgrip test, was recorded. Results: BHR and SBP were significantly higher in the study group. DBP was higher in the control group. There was a highly significant difference in hemoglobin levels, with the study group having considerably lower levels. The 30:15 ratio is higher in the study group, with a significant difference indicating that pregnant women with anemia have a higher ratio response when transitioning from a sitting to a standing position than normal pregnant women. The diastolic blood pressure increase in response to the isometric handgrip (IHG) exercise is significantly higher in the study group, indicating a more significant response to isometric handgrip in pregnant women with anemia in the early and late trimesters of pregnancy. Conclusion: Pregnant women with anemia are more prone to autonomic and cognitive dysfunction than normal pregnant women. The increased heart rate, blood pressure, and altered HRV indices highlight the need for careful monitoring and early identification of anemia during pregnancy.