拉贾斯坦邦西部正常孕妇和有妊高征危险因素孕妇妊娠早期心血管参数和心率变异性(频域分析)研究

Soniya Vyas, Raghuveer Choudhary, K. Choudhary, I. Khan
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摘要

背景:交感神经迷走神经失衡(SVI)和CV风险在妊娠高血压(PIH)中的作用已有报道,但尚未研究它们在妊娠早期与PIH的关系。因此,在本研究中,我们研究了妊娠前三个月正常孕妇和有妊高征危险因素妇女的母体心血管参数和心率变异性(HRV)的频域指数。方法:从拉贾斯坦邦Jodhpur S. n.医学院附属Umaid医院妇产科招募妊娠早期血压正常的孕妇各220例(对照组220例,有妊高征危险因素的孕妇220例,研究组220例)。进行体格检查和身高、体重等人体测量。采用HRV分析软件对收集的数据进行统计学分析。结果:两组患者体重指数差异有统计学意义。研究组收缩压、舒张压、脉压、率压积、平均动脉压均显著高于对照组。妊高征危险因素孕妇HRV频域分析中LF和LF/HF比值分量值较正常孕妇显著升高,HF分量值无显著降低。结论:本研究提示妊高征危险因素孕妇妊娠早期心血管指标明显高于正常孕妇。伴有妊高征危险因素孕妇的LF (nu)和LF/HF比值显著(HS) (p<0.000)升高,HF (nu)无显著(NS)(p<0.552)降低,提示妊高征危险因素孕妇在妊娠早期交感神经张力增高。迷走神经退缩和交感神经夸张可能是孕妇妊高征的可能原因及其危险因素。
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Study of Cardiovascular Parameters and Heart Rate Variability (Frequency Domain Analysis) in 1St Trimester of Normal Pregnant Women and Pregnant Women with Risk Factors for PIH in Western Rajasthan
Background: The role of sympathovagal imbalance (SVI) and CV risk in pregnancy-inducedhypertension (PIH) has been reported, and their association during early trimesters of gestation in PIHhas not been studied. Therefore, in the present study, we have investigated the maternal cardiovascularparameters and frequency domain indices of Heart rate variability (HRV) between normal pregnantwomen and women with risk factors for PIH in their 1st trimester of gestation.Methods: Two hundred twenty subjects each (220 of normotensive pregnant women i.e., control groupand 220 of pregnant women with risk factor for PIH i.e., study group) of 1st trimester of gestation wererecruited from the obstetrics & gynecology department of Umaid hospital, associated with Dr. S. N.Medical College, Jodhpur, Rajasthan. Physical examination was done and anthropometric measurementlike height & weight were taken. The collected data was statistically analyzed using HRV analysissoftware.Results: Significant difference in body mass index was observed between the two groups. Systolic bloodpressure, Diastolic blood pressure, Pulse pressure, Rate pressure product and Mean arterial pressure ofstudy group was significantly higher than control group. Values of LF and LF/HF ratio components offrequency domain analysis of HRV were significantly increased but HF component is non significantlydecrease in 1st trimester of the pregnant women with risk factor for PIH than normal pregnant women.Conclusion: The present study indicates that the cardiovascular parameters in 1st trimester of pregnantwomen with risk factor for PIH were increased highly significantly than the normal pregnant women.The highly significant (HS) (p<0.000) increase in the LF (nu) & LF/HF ratio and non significant (NS)(p<0.552) decrease in HF (nu) of pregnant women with risk factors for PIH was observed than normalpregnant women this indicate that sympathetic tone was increased in 1st trimester of pregnant womenwith risk factor for PIH. Vagal withdrawal and sympathetic exaggeration may be the possible cause ofPIH in pregnant women with its risk factors.
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