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Posture-related changes in sympathetic baroreflex sensitivity during normal pregnancy

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Abstract

Normal pregnancy is associated with vast adjustments in cardiovascular autonomic control. Sympathetic baroreflex sensitivity has been reported to be attenuated during pregnancy in animal models, but most studies in humans are cross-sectional and findings from longitudinal case studies are inconclusive. It remains unclear how sympathetic baroreflex sensitivity is altered longitudinally during pregnancy within an individual in different body postures. Therefore, this study examined the impact of posture on sympathetic baroreflex sensitivity in 24 normal-weight normotensive pregnant women. Spontaneous sympathetic baroreflex sensitivity was assessed during early (6–11 weeks) and late (32–36 weeks) pregnancy and 6–10 weeks postpartum in the supine posture and graded head-up tilt (30° and 60°). In addition, data from the postpartum period were compared with (and no different to) 18 age-matched non-pregnant women to confirm that the postpartum period was reflective of a non-pregnant condition (online supplement). When compared with postpartum (−3.8 ± 0.4 bursts/100 heartbeats/mmHg), supine sympathetic baroreflex sensitivity was augmented during early pregnancy (−5.9 ± 0.4 bursts/100 heartbeats/mmHg, P < 0.001). However, sympathetic baroreflex sensitivity at 30° or 60° head-up tilt was not different between any phase of gestation (P > 0.05). When compared to supine, sympathetic baroreflex sensitivity at 60° head-up tilt was significantly blunted during early (Δ2.0 ± 0.7 bursts/100 heartbeats/mmHg, P = 0.024) and late (Δ1.5 ± 0.6 bursts/100 heartbeats/mmHg, P = 0.049) pregnancy but did not change postpartum (Δ0.4 ± 0.6 bursts/100 heartbeats/mmHg, P = 1.0). These data show that time-course changes in sympathetic baroreflex sensitivity are dependent on the posture it is examined in and provides a foundation of normal blood pressure regulation during pregnancy for future studies in women at risk for adverse pregnancy outcomes.

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Acknowledgements

The authors thank the study volunteers for their participation in this study, and Rosemary S. Parker, Monique A. Roberts-Reeves, Amanda Clark, and Lauren Houston for their laboratory assistance.

Funding

This study was supported by the National Institutes of Health grants K23 (HL075283), R21 (HL088184), and R01 (HL142605), the American Heart Association Grant-in-Aid grant award (13GRNT16990064), the Harry S. Moss Heart Trust, and the American Heart Association postdoctoral fellowship award (826095).

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Authors and Affiliations

  1. Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, 7232 Greenville Avenue, Dallas, TX, 75231, USA

    Sarah L. Hissen, Ryosuke Takeda, Jeung-Ki Yoo, Mark B. Badrov, Abigail S. L. Stickford, Stuart A. Best, Yoshiyuki Okada, Sara S. Jarvis & Qi Fu

  2. The University of Texas Southwestern Medical Center, Dallas, TX, USA

    Sarah L. Hissen, Ryosuke Takeda, Jeung-Ki Yoo, David B. Nelson & Qi Fu

  3. University Health Network, Toronto, ON, Canada

    Mark B. Badrov

  4. Medtronic Plc, Minneapolis, MN, USA

    Abigail S. L. Stickford

  5. University of Kentucky, Lexington, KY, USA

    Stuart A. Best

  6. Hiroshima University, Hiroshima, Japan

    Yoshiyuki Okada

  7. Northern Arizona University, Flagstaff, AZ, USA

    Sara S. Jarvis

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  1. Sarah L. Hissen
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Contributions

SLH and QF conceived and designed the study; SLH, RT, J-KY, MBB, ASL, SAB, YO and SSJ performed experiments; SLH analyzed data; SLH, RT and QF interpreted results of manuscript, SLH and QF drafted manuscript; all authors edited, revised, and approved the final version of the manuscript.

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Correspondence to Qi Fu.

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Hissen, S.L., Takeda, R., Yoo, JK. et al. Posture-related changes in sympathetic baroreflex sensitivity during normal pregnancy. Clin Auton Res 32, 485–495 (2022). https://doi.org/10.1007/s10286-022-00903-z

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