Measuring Heart Rate Variability During Pregnancy Using Mobile Health Technology: Validity and Acceptability of the...

High levels of stress during pregnancy can impact the health of pregnant individuals and their developing infants. Wearable biosensor devices offer noninvasive, continuous monitoring of stress physiology through heart rate variability (HRV), a marker of autonomic nervous system function and emotion regulation. This study aimed to examine the validity and acceptability of the movisens EcgMove4 device for measuring heart rate (HR) and HRV in a diverse community sample of pregnant women.

Participants were 101 women (64.4% Black, 26.7% White, 2.0% multiracial) in their second or third trimester of pregnancy. HR and HRV were measured using the EcgMove4 and a traditional electrocardiogram (ECG) monitor during a 5-minute resting period. Participants then wore the EcgMove4 for 10 days and completed an exit interview providing quantitative burden ratings and qualitative feedback about their experience.

The EcgMove4 demonstrated high correlations with the reference device for HR (r = 0.95) and HRV (RMSSD; r = 0.98). Bland-Altman analyses revealed slight overestimation of HR in the third trimester (bias = 0.39 bpm). Signal quality did not differ by race but was worse for women using XL chest bands. Participants wore the device for an average of 8.9 days (9.7 h/d) and reported low perceived burden (mean = 3/10). However, 16% experienced skin irritation, and burden increased during hotter weather.

The EcgMove4 shows promise as a valid and acceptable tool for monitoring HRV during pregnancy, though potential limitations for larger body sizes should be addressed. These findings may enable future research on stress physiology and emotion regulation in perinatal mental health.