Key result
Gestational diabetes is not associated with increased risk of post-spinal hypotension.
Why the study?
Gestational diabetes mellitus has been associated with autonomic nervous system dysfunction, which may influence cardiovascular regulation during anesthesia.
Do preoperative frequency-domain HRV parameters predict post-spinal hypotension in parturients with and without gestational diabetes mellitus?
Observational (n=40)
Do preoperative frequency-domain HRV parameters predict post-spinal hypotension in parturients with and without gestational diabetes mellitus?
Absolute Event Rate: 55.6% vs 50%
p-value: p=0.726
Preoperative frequency-domain HRV parameters have limited clinical utility as a screening tool for predicting post-spinal hypotension in parturients with or without gestational diabetes.
Preoperative frequency-domain HRV lacks predictive utility for post-spinal hypotension; leaves open whether refined metrics merit prospective validation in larger cohorts.
Introduction: Subarachnoid block (SAB) is the anesthetic technique of choice for elective cesarean delivery owing to its rapid onset, reliability, and favorable maternal and neonatal outcomes. Gestational diabetes mellitus (GDM) has been associated with autonomic nervous system dysfunction, which may influence cardiovascular regulation during anesthesia. This study aimed to assess the predictive value of preoperative frequency-domain heart rate variability (HRV) parameters for post-spinal hypotension in parturients with and without GDM. Materials and Methods: In this observational study, 40 parturients undergoing elective cesarean section were enrolled, including 18 women with GDM and 22 healthy controls. Baseline HRV was assessed 1 day before surgery using a standardized 5-min electrocardiographic recording analyzed with Kubios HRV Premium software. Frequency-domain parameters, including low-frequency (LF) power, high-frequency (HF) power, and LF/HF ratio were calculated. Following SAB administration, hemodynamic variables were monitored throughout surgery and the immediate postoperative period. Hypotension was defined as systolic blood pressure below 80% of baseline. Statistical analysis was performed using SPSS version 26.0, with P < 0.05 considered statistically significant. Results: Demographic characteristics were comparable between groups. No significant differences were observed in LF power, HF power, or LF/HF ratio between GDM and healthy parturients ( P > 0.05). The incidence of hypotension was similar in both groups (55.6% vs. 50.0%; P = 0.726). Vasopressor requirements and the incidence of nausea and vomiting were also comparable. Conclusion: Preoperative frequency-domain HRV parameters showed limited predictive value for post-spinal hypotension. Parturients with GDM demonstrated autonomic and hemodynamic responses similar to healthy controls, suggesting that these findings suggest that HRV frequency-domain analysis alone may have limited clinical utility as a screening tool.
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Aishwarya et al. (2026) conducted an observational in Gestational diabetes mellitus (n=40). Gestational diabetes mellitus vs. Healthy controls was evaluated on Post-spinal hypotension (systolic blood pressure below 80% of baseline) (p=0.726). Parturients with gestational diabetes mellitus had a similar incidence of post-spinal hypotension compared to healthy controls (55.6% vs. 50.0%; P=0.726).
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