The effect of obesity on heart rate (heart period) and physiologic parameters during pregnancy.
Obesity and excess gestational weight gain (EGWG) in pregnancy increase the risk for adverse maternal and infant outcomes. Along with careful monitoring of weight gain during pregnancy, early identification of a maladaptive response to the changes of pregnancy may help to avoid adverse outcomes. Simple physiologic markers such as resting heart rate (HR), heart period (HP), and blood pressure (BP) may be powerful predictors of cardiovascular adaptation to pregnancy. This article summarizes the current state of the science regarding the effect of obesity (body mass index [BMI] > or =30 kg/m(2)) and EGWG in pregnant women at rest in laboratory settings. The impact of differences in weight gain (kg and BMI) on pregnancy outcomes is also examined. A search was conducted for articles published from 1985 to 2006 reporting data on body weight and HR or HP at rest from randomized controlled trials or controlled trials conducted in laboratory settings involving pregnant women at low or high risk for adverse pregnancy outcomes who were obese or had EGWG. A meta-analysis was conducted on the 23 studies meeting inclusion criteria to explore the relation of BMI to HR, HP, and physiologic parameters. Autonomic responsiveness was found to be diminished in obese women with a BMI > 30 kg/m(2) and in women with high risk for adverse pregnancy outcomes, which may indicate a maladaptive autonomic response that is imbalanced and disorganized and that reduces adaptation to environmental demands.
Helmreich
Rebecca Jo
RJ
University of Texas, Houston, TX, USA. rhelmreich@uth.tmc.edu
Hundley
Vanora
V
Varvel
Patricia
P
D000222:Adaptation, Physiological; D000328:Adult; D000704:Analysis of Variance; D001342:Autonomic Nervous System Diseases / Q000503:physiopathology; D015992:Body Mass Index; D042241:Early Diagnosis; D004562:Electrocardiography; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008403:Mass Screening; D009730:Nursing Assessment; D009765:Obesity / Q000150:complications*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology* / Q000517:prevention & control; D011256:Pregnancy Outcome; D012107:Research Design; D018570:Risk Assessment; D012307:Risk Factors; D014630:Vagus Nerve / Q000503:physiopathology; D015430:Weight Gain