Differences in hemodynamic, hormonal and heart rate variability parameters in complication-free pregnancies, women with preeclampsia and women with gestational diabetes mellitus: an observational retrospective analysis

Background Pregnancy induces several physiological changes to a woman’s body which are poorly understood1,2. This study aimed to investigate differences in hemodynamic, hormonal and heart rate variability parameters (HRV) in women following complication-free pregnancies (healthy), preeclampsia and gestational diabetes mellitus (GDM) after giving childbirth.

Materials Retrospective data of 60 women (healthy: n = 29, age 32.7 ± 4 years, BMI 24.2 ± 4.3 kg / m2; preeclampsia: n = 16, age 35.3 ± 4.4 years, 28.5±6.4 kg / m2; GDM, n = 15, age 32.3±6.0 years, BMI 26.4 ± 6.2 kg / m2) were included. Two visits were conducted 16 and 48 weeks after giving childbirth. Hair samples were taken for analysis of cortisol and testosterone. ECG and continuous blood pressure were recorded with the Task Force Monitor®. Data were analysed via RM-ANOVA and post-hoc testing (p≤0.05).

Results Heart rate increased in groups between visits (p = 0.03) whereas SDNN decreased (p = 0.03), RMSSD showed only an increased trend for GDM (p = 0.07). In GDM testosterone was increased compared to other groups (Visit 1: healthy; preeclampsia; GDM: 0.8 ± 37; 0.86 ± 31; 1.27 ± 0.75 Visit 2: 0.88 ± 0.37; 0.86 ± 0.31; 1.27 ± 0.63 pg / mg) (for both visits p = 0.002). Cortisol levels were only different for GDM compared to healthy individuals (Visit 1: Healthy; GDM; 13.71 ± 6.25; 18.80 ± 9.61, Visit 2: 12.29 ± 5.11; 17.84 ± 10.08 pg / mg) (p = 0.02). Hemodynamic changes from week 16 to week 48 did not differ between groups. No differences between individuals with preeclampsia and healthy individuals were found for all parameters (p > 0.05).

Conclusion The study showed higher levels of chronic stress indicators in GDM compared to healthy women following childbirth. The trend found for heart rate variability (RMSSD) underpins the hormonal findings.

Interessenskonflikt

M.L.E. has received a KESS2 / European Social Fund scholarship and travel grants from Novo Nordisk A / S and Sanofi-Aventis, research grants form Sanofi-Aventis and Dexcom. O.M. has received lecture fees from Medtronic, travel grants from Novo Nordisk A / S, Novo Nordisk AT, Novo Nordisk UK, Medtronic AT, Sanofi-Aventis, research grants from Sêr Cymru II COFUND fellowship / European Union, Novo Nordisk A / S, Dexcom, Sanofi-Aventis and Novo Nordisk AT as well as material funding from Abbott Diabetes Care. H.S. has received honoraria, travel support or unrestricted research grants by Amgen, Astra Zeneca, Boehringer-Ingelheim, Eli Lilly, MSD, Novo Nordisk and Sanofi-Aventis. GT received lecture fees or travel support from Novo Nordisk, Sanofi-Aventis, Astra Zeneca, Eli Lilly and Medtronic. The remaining authors have no relevant conflict of interest to disclose.

• Literatur

• 1 Crowther CA, Hiller JE, Moss JR, McPhee AJ, Jeffries WS, Robinson JS. Effect of Treatment of Gestational Diabetes Mellitus on Pregnancy Outcomes. N Engl J Med 2005; 352 (24) 2477-2486 . doi:10.1056/NEJMoa042973
• 2 Barbour LA, McCurdy CE, Hernandez TL, Kirwan JP, Catalano PM, Friedman JE. Cellular mechanisms for insulin resistance in normal pregnancy and gestational diabetes. Diabetes Care. 2007 30. (SUPPL. 2). doi:10.2337/dc07-s202

Publication History

Article published online:
06 May 2021