Key result
Low-frequency variability of diastolic blood pressure at 28 weeks' gestation was a significant predictor of pregnancy-induced hypertension, but not preeclampsia, after multivariate adjustment.
Why the study?
Does heart rate and blood pressure variability at 28 weeks' gestation predict the incidence of pregnancy-induced hypertension or preeclampsia in pregnant women?
Cohort (n=385)
Does heart rate and blood pressure variability at 28 weeks' gestation predict the incidence of pregnancy-induced hypertension or preeclampsia in pregnant women?
Low-frequency variability of diastolic blood pressure at 28 weeks' gestation may serve as an early predictor for pregnancy-induced hypertension, differentiating it from preeclampsia.
Spectral HR/BP measures at 28 weeks may flag later PIH risk; leaves open whether they add predictive value beyond routine factors in diverse populations.
OBJECTIVE: The aim of this study is to determine the relationship between heart rate and/or blood pressure variability, measured at 28 weeks' gestation, and the incidence of pregnancy-induced hypertension or preeclampsia. STUDY DESIGN: Secondary analysis of data from a prospectively enrolled cohort of 385 active military women in whom spectral analysis of continuous heart rate and variability was measured at 28 weeks' gestation. The primary outcome was the predictive value of spectral analysis of heart rate and blood pressure for hypertensive diseases of pregnancy. RESULTS: High-frequency heart rate variability was reduced and low-frequency variability of systolic and diastolic blood pressure increased in women who would develop pregnancy-induced hypertension but not preeclampsia. Low-frequency variability of diastolic blood pressure remained a significant predictor of pregnancy-induced hypertension but not preeclampsia after adjustment for age, weight, and blood pressure in a multivariate model. CONCLUSION: Early identification of pregnancy-induced hypertension can facilitate treatment to avoid maternal morbidity. Understanding the physiological underpinnings of the two very different diseases may lead to improved treatment and prevention. If proven effective in a broader population, the ability to differentiate pregnancy-induced hypertension from preeclampsia may reduce unnecessary iatrogenic interventions or inappropriate preterm delivery.
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McKinley et al. (2015) conducted a cohort in pregnancy-induced hypertension or preeclampsia (n=385). Heart rate and blood pressure variability was evaluated on predictive value of spectral analysis of heart rate and blood pressure for hypertensive diseases of pregnancy. Low-frequency variability of diastolic blood pressure at 28 weeks' gestation was a significant predictor of pregnancy-induced hypertension, but not preeclampsia, after multivariate adjustment.
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