C2. Maternal cardiac deceleration capacity: a novel insight into maternal autonomic function. (12th August 2016)

• Record Type: Journal Article
• Authors: Casati, D; Stampalija, T.; Ferrazzi, E.; Alberti, A.; Scebba, I.; Paganelli, A.; Di Martino, D.; Muggiasca, M. L.; Bauer, A.
• Is Part Of: Journal of maternal-fetal & neonatal medicine. Volume 29(2016)Supplement 2
• Page Start: 12
• Page End: 12
• Publication Date: 2016-08-12
• Subjects: Obstetrics -- Periodicals; Perinatology -- Periodicals; Infants (Newborn) -- Diseases -- Periodicals; Neonatology -- Periodicals; 618.2
• DOI: 10.1080/14767058.2016.1234772
• Languages: English
• ISSNs: 1476-7058

Abstract

Abstract: Objective : To explore maternal cardiac deceleration capacity (DC), a marker of autonomic function derived from heart rate variability analysis, in pregnancies complicated by intrauterine growth restriction (IUGR) and hypertensive disorders of pregnancy (HDP) associated to IUGR (HDP-IUGR) or to appropriate for gestational age fetuses (HDP-AGAf). Methods: Single-center case-control study conducted at Buzzi Children's Hospital, Milan. Maternal electrocardiograms were analyzed by Phase-Rectified Signal Averaging (PRSA) to obtain cardiac beat-to-beat DC in women with: HDP-IUGR; HDP-AGAf; severe-IUGR; mild- IUGR; uncomplicated pregnancies. IUGR was defined as abdominal circumference <5th centile; severe-IUGR was associated with umbilical artery Doppler pulsatility index42SD. Results: Two- hundred and sixty-nine women recruited. Women with HDP-IUGR ( n = 35) showed significantly higher cardiac DC compared both to controls ( n = 141) ( p = 0.003) and women with HDP-AGAf ( n = 18) ( p = 0.01). Women with severe-IUGR ( n = 14) showed significantly higher DC than controls ( p = 0.01). Women with mild-IUGR ( n = 61) as with HDPAGAf showed no differences in DC compared to controls (both p = 0.3). Conclusion: Elevated cardiac deceleration capacity proves autonomic alterations in mothers with severe placental failure. We present a new bedside approach to explore maternal autonomic cardiovascular regulation that might reflect the severity of placental vascular insufficiency.