Circadian Rhythm of Heart Rate and Heart Rate Variability in Pregnancy

The autonomic nervous system (ANS) regulates physiological changes during pregnancy, supporting fetal development and homeostasis. Heart rate (HR) and heart rate variability (HRV) are non-invasive ANS biomarkers; however, their circadian rhythms during pregnancy remain underexplored due to the lack of continuous data collection, a gap now addressed by wearable technology. This study is the first comprehensive investigation of HR and HRV circadian rhythms throughout pregnancy using wearable devices in a free-living environment. We extract longitudinal HR and HRV from smartwatch photoplethysmography (PPG) data via a machine learning-based pipeline and employ Cosinor analysis to assess circadian rhythm characteristics. Our findings revealed significant HR and HRV circadian patterns over 16 weeks, showing a decline in HRV and an increase in HR rhythm-adjusted mean, as well as elevated nighttime stress linked to sleep disturbances and daytime fatigue. These results offer valuable insights into ANS regulation during pregnancy and highlight potential biomarkers for pregnancy complications.