Monitoring one heart to help two: heart rate variability and resting heart rate using wearable technology in active women across the perinatal period

Springer Science and Business Media LLC - Tập 22 - Trang 1-9 - 2022
Shon P. Rowan1, Christa L. Lilly2, Elizabeth A. Claydon3, Jenna Wallace4, Karen Merryman1
1Department of Obstetrics and Gynecology, West Virginia University School of Medicine, Morgantown, USA
2Department of Biostatistics, West Virginia University School of Public Health, Morgantown, USA
3Department of Social & Behavioral Sciences, West Virginia University School of Public Health, Morgantown, USA
4Departments of Behavioral Medicine & Psychiatry and Pediatrics, West Virginia University School of Medicine, Morgantown, USA

Tóm tắt

Characterizing normal heart rate variability (HRV) and resting heart rate (RHR) in healthy women over the course of a pregnancy allows for further investigation into disease states, as pregnancy is the ideal time period for these explorations due to known decreases in cardiovascular health. To our knowledge, this is the first study to continuously monitor HRV and RHR using wearable technology in healthy pregnant women. A total of 18 healthy women participated in a prospective cohort study of HRV and RHR while wearing a WHOOP® strap prior to conception, throughout pregnancy, and into postpartum. The study lasted from March 2019 to July 2021; data were analyzed using linear mixed models with splines for non-linear trends. Eighteen women were followed for an average of 405.8 days (SD = 153). Minutes of logged daily activity decreased from 28 minutes pre-pregnancy to 14 minutes by third trimester. A steady decrease in daily HRV and increase in daily RHR were generally seen during pregnancy (HRV Est. = − 0.10, P < 0.0001; RHR Est. = 0.05, P < 0.0001). The effect was moderated by activity minutes for both HRV and RHR. However, at 49 days prior to birth there was a reversal of these indices with a steady increase in daily HRV (Est. = 0.38, P < 0.0001) and decrease in daily RHR (Est. = − 0.23, P < 0.0001), regardless of activity level, that continued into the postpartum period. In healthy women, there were significant changes to HRV and RHR throughout pregnancy, including a rapid improvement in cardiovascular health prior to birth that was not otherwise known. Physical activity minutes of any type moderated the known negative consequences of pregnancy on cardiovascular health. By establishing normal changes using daily data, future research can now evaluate disease states as well as physical activity interventions during pregnancy and their impact on cardiovascular fitness. • Continuous monitoring of heart rate variability and resting heart rate throughout the perinatal period has not been previously performed. • Prior studies have indicated heart rate variability changes per trimester. However, at 49 days prior to delivery there is a reversal of the changes not previously seen. • Most patients are not currently wearing a physiologic monitor. If further research shows significant changes in disease states, using physiologic monitors may become an important part of obstetric management.

Tài liệu tham khảo

Birsner ML, Gyamfi-Bannerman C. Physical activity and exercise during pregnancy and the postpartum period: ACOG Committee opinion, number 804. Obstet Gynecol. 2020;135(4):e178–88. Wagnild JM, Pollard TM. “Sit yourself down”: Women’s experiences of negotiating physical activity during pregnancy. Qual Health Res. 2020;30(7):1072–82. Hassan A, Meah VL, Davies GA, Davenport MH, Siassakos D. Modify, don't stop! Time to reconsider the 'relative' and 'absolute' contraindications to physical activity in pregnancy: an opinion piece. BJOG. 2022;129(3):331–5. Bauer PW, Broman CL, Pivarnik JM. Exercise and pregnancy knowledge among healthcare providers. J Women's Health (Larchmt). 2010;19(2):335–41. Bull FC, Al-Ansari SS, Biddle S, Borodulin K, Buman MP, Cardon G, et al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. Br J Sports Med. 2020;54(24):1451–62. Jimah T, Borg H, Kehoe P, Pimentel P, Turner A, Labbaf S, et al. A technology-based pregnancy health and wellness intervention (two happy hearts): case study. JMIR Form Res. 2021;5(11):e30991. Capodilupo ER, Miller DJ. Changes in health promoting behavior during COVID-19 physical distancing: utilizing wearable technology to examine trends in sleep, activity, and cardiovascular indicators of health. PLoS One. 2021;16(8):e0256063. Georgiou K, Larentzakis AV, Khamis NN, Alsuhaibani GI, Alaska YA, Giallafos EJ. Can wearable devices accurately measure heart rate variability? A Systematic Review. Folia Med (Plovdiv). 2018;60(1):7–20. Sztajzel J. Heart rate variability: a noninvasive electrocardiographic method to measure the autonomic nervous system. Swiss Med Wkly. 2004;134(35–36):514–22. Reimers AK, Knapp G, Reimers CD. Effects of exercise on the resting heart rate: a systematic review and Meta-analysis of interventional studies. J Clin Med. 2018;7(12):503. Plews DJ, Laursen PB, Kilding AE, Buchheit M. Heart rate variability in elite triathletes, is variation in variability the key to effective training? A case comparison. Eur J Appl Physiol. 2012;112(11):3729–41. May LE, Knowlton J, Hanson J, Suminski R, Paynter C, Fang X, et al. Effects of exercise during pregnancy on maternal heart rate and heart rate variability. PM R. 2016;8(7):611–7. Solanki JD, Desai FH, Desai KH. Heart rate variability is reduced in normal pregnancy irrespective of trimester: a cross-sectional study from Gujarat, India. J Family Med Prim Care. 2020;9(2):626–31. Saarikko J, Niela-Vilen H, Ekholm E, Hamari L, Azimi I, Liljeberg P, et al. Continuous 7-month internet of things-based monitoring of health parameters of pregnant and postpartum women: prospective observational feasibility study. JMIR Form Res. 2020;4(7):e12417. Niela-Vilén H, Auxier J, Ekholm E, Sarhaddi F, Asgari Mehrabadi M, Mahmoudzadeh A, et al. Pregnant women's daily patterns of well-being before and during the COVID-19 pandemic in Finland: longitudinal monitoring through smartwatch technology. PLoS One. 2021;16(2):e0246494. Berryhill S, Morton CJ, Dean A, Berryhill A, Provencio-Dean N, Patel SI, et al. Effect of wearables on sleep in healthy individuals: a randomized crossover trial and validation study. J Clin Sleep Med. 2020;16(5):775–83. SAS Institute Inc. SAS/ACCESS(R) 9.4 Interface to ADABAS:reference. Cary: SAS Institute Inc.; 2013. Piercy KL, Troiano RP, Ballard RM, Carlson SA, Fulton JE, Galuska DA, et al. The physical activity guidelines for Americans. JAMA. 2018;320(19):2020–8. May LE, Glaros A, Yeh HW, Clapp JF 3rd, Gustafson KM. Aerobic exercise during pregnancy influences fetal cardiac autonomic control of heart rate and heart rate variability. Early Hum Dev. 2010;86(4):213–7. May LE, Suminski RR, Berry A, Langaker MD, Gustafson KM. Maternal physical activity mode and fetal heart outcome. Early Hum Dev. 2014;90(7):365–9. Prather H, Spitznagle T, Hunt D. Benefits of exercise during pregnancy. PM R. 2012;4(11):845–50 quiz 850. Kalisiak B, Spitznagle T. What effect does an exercise program for healthy pregnant women have on the mother, fetus, and child? PM R. 2009;1(3):261–6. Kimmel MC, Fransson E, Cunningham JL, Brann E, Grewen K, Boschiero D, et al. Heart rate variability in late pregnancy: exploration of distinctive patterns in relation to maternal mental health. Transl Psychiatry. 2021;11(1):286. McGee LD, Cignetti CA, Sutton A, Harper L, Dubose C, Gould S. Exercise during pregnancy: Obstetricians' beliefs and recommendations compared to American Congress of Obstetricians and Gynecologists' 2015 guidelines. Cureus. 2018;10(8):e3204.