Key result
During pregnancy, daily heart rate variability steadily decreased (Est. -0.10) and resting heart rate increased, but these trends reversed 49 days prior to birth with a steady increase in HRV and decrease in RHR.
Why the study?
Characterizing normal heart rate variability and resting heart rate across healthy pregnancy allows for further investigation into disease states, but continuous monitoring using wearable technology had not been performed.
Cohort (n=18)
No
Effect estimate: Est. -0.10
p-value: p=<0.0001
Continuous wearable monitoring in healthy pregnant women demonstrates a steady decline in HRV and increase in RHR during pregnancy, with a notable reversal of these trends 49 days prior to delivery.
Wearable HRV/RHR monitoring may support remote pregnancy surveillance; leaves open impact on outcomes before clinical adoption.
BACKGROUND: Characterizing normal heart rate variability (HRV) and resting heart rate (RHR) in healthy women over the course of a pregnancy allows for further investigation into disease states, as pregnancy is the ideal time period for these explorations due to known decreases in cardiovascular health. To our knowledge, this is the first study to continuously monitor HRV and RHR using wearable technology in healthy pregnant women. METHODS: A total of 18 healthy women participated in a prospective cohort study of HRV and RHR while wearing a WHOOP® strap prior to conception, throughout pregnancy, and into postpartum. The study lasted from March 2019 to July 2021; data were analyzed using linear mixed models with splines for non-linear trends. RESULTS: Eighteen women were followed for an average of 405.8 days (SD = 153). Minutes of logged daily activity decreased from 28 minutes pre-pregnancy to 14 minutes by third trimester. A steady decrease in daily HRV and increase in daily RHR were generally seen during pregnancy (HRV Est. = - 0.10, P < 0.0001; RHR Est. = 0.05, P < 0.0001). The effect was moderated by activity minutes for both HRV and RHR. However, at 49 days prior to birth there was a reversal of these indices with a steady increase in daily HRV (Est. = 0.38, P < 0.0001) and decrease in daily RHR (Est. = - 0.23, P < 0.0001), regardless of activity level, that continued into the postpartum period. CONCLUSIONS: In healthy women, there were significant changes to HRV and RHR throughout pregnancy, including a rapid improvement in cardiovascular health prior to birth that was not otherwise known. Physical activity minutes of any type moderated the known negative consequences of pregnancy on cardiovascular health. By establishing normal changes using daily data, future research can now evaluate disease states as well as physical activity interventions during pregnancy and their impact on cardiovascular fitness.
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Rowan et al. (2022) conducted a cohort in Healthy pregnancy (n=18). Pregnancy vs. Pre-pregnancy baseline was evaluated on Daily change in heart rate variability (HRV) during pregnancy (up to 49 days prior to delivery) (Est. -0.10, p=<0.0001). During pregnancy, daily heart rate variability steadily decreased (Est. -0.10) and resting heart rate increased, but these trends reversed 49 days prior to birth with a steady increase in HRV and decrease in RHR.
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