Related Experiment Video
Updated: Mar 28, 2026
Calculating Heart Rate Variability from ECG Data from Youth with Cerebral Palsy During Active Video Game Sessions
Published on: June 5, 2019
Heart rate variability in neonates of type 1 diabetic pregnancy
Noirin E Russell1, Mary F Higgins1, Brendan F Kinsley2
1UCD Obstetrics and Gynaecology, School of Medicine and Medical Science, University College Dublin National Maternity Hospital, Dublin 2, Ireland.
Insights
Neonates born to mothers with pregestational type 1 diabetes exhibit altered heart rate variability (HRV). This change in HRV is linked to maternal hyperglycemia and fetal factors, potentially increasing cardiovascular risk later in life.
Area of Science:
- Neonatal physiology
- Maternal-fetal medicine
- Cardiovascular health
Background:
- Offspring of pre-gestational type 1 diabetic pregnancies often show cardiac dysfunction.
- Maternal hyperglycemia may program fetal cardiac development, increasing long-term cardiovascular risk.
- Neonatal heart rate variability (HRV) changes are associated with adverse outcomes, but its link to diabetic pregnancy is unknown.
Purpose of the Study:
- To investigate differences in neonatal heart rate variability (HRV) between infants from diabetic and normal pregnancies.
- To assess the impact of maternal diabetes on fetal cardiac autonomic function.
Main Methods:
- Prospective observational study comparing 38 infants of mothers with pregestational type 1 diabetes to 26 controls.
- Neonatal heart rate variability (HRV) assessed using Powerlab.
- Cord blood samples analyzed for pH and glucose; maternal HbA1c measured throughout pregnancy.
Main Results:
- Infants of diabetic mothers showed altered heart rate variability (HRV), indicated by an increased low frequency to high frequency (LF:HF) ratio.
- This suggests a shift towards sympathetic nervous system predominance in neonates exposed to maternal diabetes.
- Altered HRV correlated significantly with fetal acidaemia, cord glucose, and maternal glycemic control.
Conclusions:
- Neonates from pre-gestational diabetic pregnancies exhibit altered heart rate variability (HRV).
- This alteration is associated with maternal hyperglycemia, fetal acidaemia, and fetal glycaemia.
- Changes in HRV due to in-utero glycemic fluctuations may contribute to the increased cardiovascular disease risk in offspring of diabetic mothers.
Background:
Cardiomyopathy is a common finding in offspring of pre-gestational type 1 diabetic pregnancy. Echocardiographic and biochemical evidence of fetal cardiac dysfunction have also been reported. Studies suggest that offspring of diabetic mothers (ODM) undergo a fetal programming effect due to the hyperglycaemic intrauterine milieu which increases their risk of cardiovascular morbidity in adult life. Decreased neonatal heart rate variability (HRV) has been described in association with in-utero growth restriction, prematurity, sudden infant death syndrome and congenital heart disease. The effect of in-utero exposure to hyperglycaemia in diabetic pregnancy on neonatal HRV is unknown.
Aims:
Our aim was to determine if neonatal HRV differs between normal and diabetic pregnancy.
Study Design And Subjects:
This was a prospective observational study of 38 patients with pregestational type 1 diabetes and 26 controls. HRV assessment was performed using Powerlab (ADI Instruments Ltd).
Outcome Measures:
Heart rate variability assessment and cord blood sampling for pH and glucose were performed for all neonates. Maternal glycaemic control was assessed via measurement of glycosylated haemoglobin in each trimester in the diabetic cohort.
Results:
Neonates of diabetic mothers had evidence of altered heart rate variability, with increased low frequency to high frequency ratio (LF: HF), suggestive of a shift towards sympathetic predominance (p<0.05). This altered HRV was significantly related to fetal acidaemia, cord blood glucose values and maternal glycaemic control during pregnancy (p<0.05).
Conclusion:
Neonates of pregestational diabetic pregnancy have altered HRV which is related to maternal hyperglycaemia, fetal acidaemia and fetal glycaemia. Exposure of the developing heart to fluctuations in maternal glycaemia with subsequent alterations in HRV may explain why infants of diabetic mothers are at greater risk of cardiovascular disease in later life.
Related Concept Videos
01:22Diabetes Mellitus: Type 2 and Gestational
01:20Pathophysiology of Diabetes
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility,...
01:14Fetal Circulation
Two umbilical arteries transport blood from the fetus to the placenta. At the placenta, the blood absorbs oxygen and nutrients while simultaneously eliminating waste products. This oxygen-enriched and nutrient-rich blood then returns to the fetus through one...
01:22Diabetes Mellitus: Overview and Type I Subtype
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
01:30Factors Influencing Heart Rate
Let us explore the significant factors affecting heart rate, including age, body temperature, posture, acute pain, chemical influences,...
01:31Regulation of Heart Rates
The SNS increases heart rate through the release of norepinephrine and epinephrine, which act on beta-1 adrenergic receptors in the heart. This action increases the rate of depolarization in the sinoatrial (SA) node, the heart's...