Blood Pressure and Heart Rate Variability and the Impact on Pregnancy Outcomes: A Systematic Review

Area of Science:

• Obstetrics and Gynecology
• Cardiovascular Medicine
• Perinatal Health

Background:

• Long-term blood pressure variability (BPV) and heart rate variability (HRV) are linked to cardiovascular risks.
• Identifying high-risk pregnancies often relies on blood pressure levels alone.
• Long-term BPV and HRV may offer additional prognostic insights during pregnancy.

Approach:

• A systematic review was conducted to analyze the association between long-term BPV and HRV in pregnancy and adverse maternal/perinatal outcomes.
• Searched databases from inception to May 2023 for relevant studies.
• Included studies with sufficient blood pressure or heart rate measurements, excluding short-term variability.

Key Points:

• Eight studies (138,949 pregnancies) reported on BPV; no studies reported on HRV.
• Elevated BPV was observed in women with hypertension and preeclampsia.
• Greater BPV correlated with increased adverse pregnancy outcomes, including maternal hypertension and fetal growth restriction, irrespective of mean blood pressure.

Conclusions:

• Long-term BPV shows significant associations with adverse maternal and fetal outcomes in pregnancy.
• Further research is needed to validate BPV for prospective risk stratification in pregnancy.
• Optimal management strategies for high-risk pregnancies identified by BPV require determination.