Effects of human pregnancy on cardiac autonomic function above and below the ventilatory threshold

Avery, Nicole; Wolfe, Larry A.; Amara, Catherine E.; Davies, Gregory; McGrath, Michael J.

doi:10.1152/jappl.2001.90.1.321

Cited by 59 publications

(75 citation statements)

References 35 publications

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“…The progressive increase in PEF after 14-16 weeks of gestation is in concordance with previously reported bronchodilatation occurring during pregnancy. 28 The physiological mechanisms of bronchodilatation in pregnancy remain unclear, but pregnancy-induced reduction in pulmonary vagal efferent activity, 29 and progesterone-mediated alteration in airway smooth muscle tone, [30][31][32] may separately or in combination be responsible.…”

Section: Discussionmentioning

confidence: 99%

Changes in pulmonary function during pregnancy: a longitudinal cohort study

Grindheim

Toska

et al. 2011

BJOG

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Objective To record any physiological changes in lung function during healthy pregnancies, and evaluate the influence of parity, pregestational overweight, and excessive weight gain.Design Longitudinal cohort study.Setting Antenatal clinic at Oslo University Hospital.Population One hundred healthy white women with singleton pregnancies.Methods The women were studied with repeated measures of lung function using spirometry at a gestational age of 14-16, 22-24, 30-32, and 36 weeks, and at 6 months postpartum.Main outcome measures Forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and peak expiratory flow (PEF), also expressed as a percentage of predicted values according to age and height: i.e. FVC%, FEV1%, and PEF%.Results Both FVC and FVC% increased significantly after 14-16 weeks of gestation (P = 0.001), as was the case for both PEF and PEF% (P < 0.001). FVC, FVC%, PEF, and PEF% in early and mid-pregnancy were significantly lower compared with the postpartum value (all P < 0.05). Nulliparous women had an overall 4.4% lower value of FVC% than parous women (P = 0.039). There were no differences in FVC, FEV1, or PEF dependent upon pregestational overweight or excessive weight gain.Conclusions Forced vital capacity (FVC) increases significantly after 14-16 weeks of gestation. The FVC% is significantly higher in parous compared with primigravida women, suggesting that the changes in FVC occurring during pregnancy persist postpartum. PEF increases significantly during healthy pregnancies, and should be interpreted cautiously in pregnant women with impaired lung function.

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Section: Discussionmentioning

confidence: 99%

Changes in pulmonary function during pregnancy: a longitudinal cohort study

Grindheim

Toska

et al. 2011

BJOG

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“…The latter was shown to be an interesting stress indicator (Nater et al, 2005;Rohleder, Nater, Wolf, Ehlert, & Kirschbaum, 2004). Women at the beginning of the second and third trimesters of their pregnancy were assessed, based on the knowledge that there are differences in physiological baseline levels and stress responses (Avery, Wolfe, Amara, Davies, & McGrath, 2001;Mastorakos & Ilias, 2003;Nierop et al, 2006;Petraglia et al, 2001;Wang, Zhang, & Zhao, 1999), as well as evidence of differences in psychological stress responses (Glynn, Wadhwa, Dunkel-Schetter, Chicz-Demet, & Sandman, 2001;Paarlberg et al, 1999) at different stages of pregnancy.…”

Section: Introductionmentioning

confidence: 99%

Stress-buffering effects of psychosocial resources on physiological and psychological stress response in pregnant women

Nierop

Wirtz

Bratsikas

et al. 2008

Biological Psychology

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Stress-buffering effects of psychosocial resources on physiological and psychological stress response in pregnant women been brought in association with psychosocial resources (self-efficacy and daily uplifts). Predictions revealed that higher resources predict lower physiological and psychological stress responses and higher mood levels. We conclude from our data that psychosocial resources appear to dampen psychological and physiological stress response during pregnancy.

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“…Experiments have assessed the site(s) within the baroreflex arc that are functionally depressed. Initial studies documented depressed baroreflex control of multiple efferents, including heart rate (5,21,24,123,175,193), renal and muscle sympathetic nerve activity (79,89,148,149), and hormones such as vasopressin and ACTH/glucocorticoids (26,104). Multiple approaches have been used to assess the effect of pregnancy on reflex control of the autonomic nervous system (for reviews, see Refs.…”

mentioning

confidence: 99%

“…Pharmacological blockade of the sympathetic or parasympathetic nervous systems has revealed that the sympathetic contribution to heart rate baroreflex curves is particularly blunted (21,123). In addition, pregnancy-induced decreases in baroreflex function in humans and rats have been successfully detected via measurement of spontaneous baroreflex sensitivity, which identifies brief spontaneous baroreflexmediated ramps in which systolic pressure and pulse interval both simultaneously increase or decrease (5,24,175,193). This measurement is restricted to the more linear segment of baroreflex curves close to basal values and highlights in particular the impact of rapid changes in parasympathetic control of the heart, documenting that pregnancy depresses these aspects of baroreflex function as well.…”

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confidence: 99%

Pregnancy and the endocrine regulation of the baroreceptor reflex

Brooks

Dampney

Heesch

2010

American Journal of Physiology-Regulatory, Integrative and Comp

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-The purpose of this review is to delineate the general features of endocrine regulation of the baroreceptor reflex, as well as specific contributions during pregnancy. In contrast to the programmed changes in baroreflex function that occur in situations initiated by central command (e.g., exercise or stress), the complex endocrine milieu often associated with physiological and pathophysiological states can influence the central baroreflex neuronal circuitry via multiple sites and mechanisms, thereby producing varied changes in baroreflex function. During pregnancy, baroreflex gain is markedly attenuated, and at least two hormonal mechanisms contribute, each at different brain sites: increased levels of the neurosteroid 3␣-hydroxydihydroprogesterone (3␣-OH-DHP), acting in the rostral ventrolateral medulla (RVLM), and reduced actions of insulin in the forebrain. 3␣-OH-DHP appears to potentiate baroreflex-independent GABAergic inhibition of premotor neurons in the RVLM, which decreases the range of sympathetic nerve activity that can be elicited by changes in arterial pressure. In contrast, reductions in the levels or actions of insulin in the brain blunt baroreflex efferent responses to increments or decrements in arterial pressure. Although plasma levels of angiotensin II are increased in pregnancy, this is not responsible for the reduction in baroreflex gain, although it may contribute to the increased level of sympathetic nerve activity in this condition. How these different hormonal effects are integrated within the brain, as well as possible interactions with additional potential neuromodulators that influence baroreflex function during pregnancy and other physiological and pathophysiological states, remains to be clearly delineated.3␣-hydroxy-dihydroprogesterone; angiotensin II; insulin; paraventricular nucleus of the hypothalamus NORMAL PREGNANCY is characterized by profound changes in fluid and electrolyte balance and blood pressure regulation. Blood volume and cardiac output increase by 30 -50%, but arterial pressure falls due to even greater decreases in systemic vascular resistance (120,138,189). These hemodynamic alterations are evident early in pregnancy, precede the increases in uterine blood flow, and are sustained until parturition (127,138,189). Considerable data implicate increases in relaxin and nitric oxide (NO) in the systemic vasodilation induced by pregnancy (20,127,128,177,196). In addition, peripheral vascular sensitivity to circulating vasoconstrictors including vasopressin, angiotensin II (ANG II), and norepinephrine (NE) is decreased (50,71,154).Unlike the hemodynamic changes, which likely subserve adequate fetal development, an adverse consequence of normal pregnancy is a marked impairment of the arterial baroreceptor reflex. This change was first noted by Humphreys and Joels (97,98) in an extensive series of studies in anesthetized pregnant rabbits, in which reductions in carotid sinus pressure failed to elicit normal increases in arterial pressure and peripheral vascular resistanc...

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Effects of human pregnancy on cardiac autonomic function above and below the ventilatory threshold

Cited by 59 publications

References 35 publications

Changes in pulmonary function during pregnancy: a longitudinal cohort study

Changes in pulmonary function during pregnancy: a longitudinal cohort study

Stress-buffering effects of psychosocial resources on physiological and psychological stress response in pregnant women

Pregnancy and the endocrine regulation of the baroreceptor reflex

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