Autonomic modulation in gestational diabetes mellitus

• Published in: Journal of diabetes and its complications Vol. 28; no. 5; pp. 684 - 688
• Main Authors: Maser, Raelene E, Lenhard, M. James, Kolm, Paul
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.09.2014; Elsevier Limited
• Subjects: Adolescent; Adult; Autonomic nervous system; Autonomic Nervous System - physiopathology; Blood pressure; Cardiovascular autonomic function; Cardiovascular disease; Cardiovascular System - physiopathology; Diabetes; Diabetes, Gestational - physiopathology; Endocrinology & Metabolism; Female; Follow-Up Studies; Gestational diabetes mellitus; Glucose; Heart; Heart rate; Heart Rate - physiology; Heart rate variability; Humans; Insulin; Postpartum Period - physiology; Posture; Pregnancy; Pregnancy Trimester, Third; Supine Position - physiology; Young Adult; Pregnancy; Gestational diabetes mellitus; Cardiovascular autonomic function; Autonomic nervous system; Heart rate variability
• ISSN: 1056-8727; 1873-460X
• DOI: 10.1016/j.jdiacomp.2014.05.005

Abstract Aims The aim of this study was to evaluate the influence of gestational diabetes mellitus (GDM) and positional aortocaval compression on cardiovascular autonomic nervous system (ANS) function in late pregnancy. Methods Pregnant women with ( n = 31) and without ( n = 12) GDM were evaluated at 30–35 weeks gestation and 2–3 months postpartum. Measures of ANS function included power spectral analysis (performed sitting) and RR-variation during deep breathing (performed supine). Time-related changes (late pregnancy versus 2–3 months postpartum) for measurements of cardiovascular ANS function were analyzed using multivariate analysis of variance for repeated measures. Results Baseline characteristics were similar for both groups. Comparing ANS measures for GDM + versus GDM − women during pregnancy and postpartum revealed no significant differences. Time related changes indicated that during late pregnancy total spectral power, low frequency (LF) power, high frequency (HF) power, and RR-variation during deep breathing were significantly reduced ( p < 0.001 for all). The LF/HF ratio, however, was not significantly affected during late pregnancy ( p = 0.678). Conclusions Our results suggest decreased activity in both branches of the ANS during mid-third trimester pregnancy, but no significant change in sympathovagal balance. Aortocaval compression appears to affect ANS function whether tests were performed sitting or supine for GDM + and GDM − women.