Physiology/Endocrinology
Poster Session 2
Stephanie A. Fisher, MD, MPH (she/her/hers)
Assistant Professor of Obstetrics and Gynecology
Northwestern University Feinberg School of Medicine
Chicago, IL, United States
Xiaoning Huang, PhD
Northwestern University Feinberg School of Medicine
Chicago, IL, United States
Sadiya S. Khan, MD, MSc
Assistant Professor of Medicine
Northwestern University Feinberg School of Medicine
Oak Park, IL, United States
Daniela Grimaldi, MD, PhD
Research Assistant Professor of Neurology (Sleep Medicine)
Northwestern University Feinberg School of Medicine
Chicago, IL, United States
Phyllis Zee, MD, PhD
Northwestern University Feinberg School of Medicine
Chicago, IL, United States
Philip Greenland, MD
Northwestern University Feinberg School of Medicine
Evanston, IL, United States
Francesca Facco, MD, MS
Associate Professor
Magee-Womens Hospital
Pittsburgh, PA, United States
Robert C. Basner, MD
Emeritus Professor
Columbia University
New York, NY, United States
Judith H. Chung, PhD,MD,PhD
Professor of Clinical Obstetrics and Gynecology
UC Irvine Health
Orange, CA, United States
William A. Grobman, MD, MBA
Professor
The Ohio State University
Columbus, Ohio, United States
Rebecca B. McNeil, PhD
RTI
Durbam, NC, United States
Grace W. Pien, MD, MSCE
Assistant Professor of Medicine
Johns Hopkins University School of Medicine
Baltimore, MD, United States
Uma M. Reddy, MD, MPH
Professor and Vice Chair of Research, Department of Obstetrics and Gynecology
Columbia University
New York, New York, United States
Susan Redline, MD, MPH
Peter C. Farrell Professor of Sleep Medicine
Harvard Medical School
Boston, MA, United States
Robert M. Silver, MD
University of Utah Health
Salt Lake City, UT, United States
Lynn M. Yee, MD, MPH (she/her/hers)
Associate Professor
Northwestern University
Chicago, IL, United States
Prior data suggest nocturnal heart rate (NHR) may represent a marker of cardiometabolic disease risk in non-pregnant adults, but data on NHR and pregnancy outcomes are limited. We sought to assess the association of NHR with gestational diabetes (GDM) and hypertensive disorders of pregnancy (HDP).
Study Design:
This is a secondary analysis of nulliparas enrolled in a prospective observational cohort at 8 clinical sites who completed a home sleep study using the Embletta-Gold device with bipolar electrocardiogram at baseline (60-136 weeks) and follow-up visits (220-296 weeks). We excluded those with chronic hypertension or pregestational diabetes. The primary exposure was the mean NHR at baseline and follow-up (analyzed separately). Secondary exposures were the minimum and maximum NHR at each visit. The outcomes were GDM and HDP. Independent samples t-tests compared each exposure among gravidas with and without the outcomes of interest. Multivariable logistic regression models estimated the odds of each outcome per 5-beat increase in NHR at baseline and follow-up.
Results: Among 2,952 eligible nulliparas, 4.1% (118/2911) developed GDM and 13.6% (392/2890) developed HDP. The mean (standard deviation) for the mean, minimum, and maximum NHR was 71 (8), 46 (11), and 102 (14) at baseline, and 78 (9), 51 (13), and 108 (15) at follow-up. Gravidas who developed GDM had higher mean, minimum, and maximum NHR at baseline and follow-up than unaffected gravidas (p ≤ 0.01, Table), with each exposure associated with higher adjusted odds of GDM. Gravidas who developed HDP also had higher mean NHR (baseline and follow-up), higher minimum NHR (baseline), and higher maximum NHR (follow-up) (p < 0.01) than those without HDP. For each 5-beat increase in mean NHR at the baseline visit, the adjusted odds of GDM and HDP were higher by 39% and 10%, respectively, with similar increased odds at follow-up.
Conclusion:
Higher mean, minimum, and maximum NHR in pregnancy appear to be associated with higher odds of GDM and HDP. This may reflect increased sympathetic and/or decreased parasympathetic activity in affected gravidas.