{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T07:33:10Z","timestamp":1764055990167,"version":"3.45.0"},"reference-count":48,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T00:00:00Z","timestamp":1744243200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["U10 HD063036","U10 HD063072","U10 HD063047","U10 HD063037","U10 HD063041","U10 HD063020","U10 HD063046","U10 HD063048","U10 HD063053"],"award-info":[{"award-number":["U10 HD063036","U10 HD063072","U10 HD063047","U10 HD063037","U10 HD063041","U10 HD063020","U10 HD063046","U10 HD063048","U10 HD063053"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pregnancy"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Prior data suggest that higher nocturnal heart rate may represent a marker of cardiometabolic disease risk in nonpregnant adults. Data on nocturnal heart rate and pregnancy outcomes are limited. We sought to assess the association of maternal nocturnal heart rate with adverse pregnancy outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This is a secondary analysis of nulliparas in a prospective cohort at eight US sites undergoing a home sleep study using the Embletta\u2010Gold device with bipolar electrocardiogram at baseline (6\n                      <jats:sup>0<\/jats:sup>\n                      \u201315\n                      <jats:sup>6<\/jats:sup>\n                      \u00a0weeks) and follow\u2010up (22\n                      <jats:sup>0<\/jats:sup>\n                      \u201331\n                      <jats:sup>6<\/jats:sup>\n                      \u00a0weeks) visits. Exposures were mean, minimum, and maximum nocturnal heart rate at baseline and follow\u2010up (analyzed separately). Outcomes of interest were gestational diabetes, hypertensive disorders of pregnancy, preterm birth, small\u2010for\u2010gestational age, and stillbirth. Multivariable logistic regression models estimated the odds of each outcome, except for stillbirth due to low frequency, per each 5\u2010beat higher nocturnal heart rate, adjusted for possible confounders.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 2952 eligible nulliparas, 30% experienced an adverse pregnancy outcome. We identified higher adjusted odds of gestational diabetes (minimum nocturnal heart rate mean\u00a0\u00b1\u00a0standard deviation, gestational diabetes vs. no gestational diabetes: 49\u00a0\u00b1\u00a010\u00a0vs. 46\u00a0\u00b1\u00a011; adjusted odds ratio [aOR] 1.15, 95% confidence interval [CI] 1.03\u20131.29) and hypertensive disorders of pregnancy (48\u00a0\u00b1\u00a011\u00a0vs. 46\u00a0\u00b1\u00a011; aOR 1.05, 95% CI 1.01\u20131.10) for each 5\u2010beat higher minimum nocturnal heart rate at baseline; adjusted odds of gestational diabetes were also higher at baseline and follow\u2010up for mean and maximum nocturnal heart rate. At follow\u2010up, we identified lower adjusted odds of small\u2010for\u2010gestational age for each 5\u2010beat higher mean (76\u00a0\u00b1\u00a010\u00a0vs. 78\u00a0\u00b1\u00a09; aOR 0.83, 95% CI 0.78\u20130.88) and minimum nocturnal heart rate (48\u00a0\u00b1\u00a012\u00a0vs. 51\u00a0\u00b1\u00a013; aOR 0.90, 95% CI 0.86\u20130.94).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Higher mean, minimum, and\/or maximum nocturnal heart rate in pregnancy were associated with higher odds of hypertensive disorders of pregnancy and gestational diabetes. This may reflect higher sympathetic and\/or decreased parasympathetic activity in affected gravidas. Conversely, lower mean and minimum nocturnal heart rate in late pregnancy were associated with higher odds of small\u2010for\u2010gestational age, which may be reflective of maladaptive hemodynamic changes in affected gravidas.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pmf2.70015","type":"journal-article","created":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T23:32:31Z","timestamp":1744327951000},"source":"Crossref","is-referenced-by-count":0,"title":["Association of maternal nocturnal heart rate and adverse pregnancy outcomes"],"prefix":"10.1002","volume":"1","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-5085-1163","authenticated-orcid":false,"given":"Stephanie A.","family":"Fisher","sequence":"first","affiliation":[{"name":"Division of Maternal\u2010Fetal Medicine Department of Obstetrics and Gynecology Northwestern University Feinberg School of Medicine  Chicago Illinois 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C.","family":"Zee","sequence":"additional","affiliation":[{"name":"Division of Sleep Medicine Department of Neurology Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip","family":"Greenland","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine Northwestern University Feinberg School of Medicine  Chicago Illinois USA"},{"name":"Department of Preventive Medicine Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William A.","family":"Grobman","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2010Fetal Medicine Department of Obstetrics and Gynecology The Warren Alpert Medical School of Brown University  Providence Rhode Island USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert M.","family":"Silver","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2010Fetal Medicine Department of Obstetrics and Gynecology University of Utah School of Medicine  Salt Lake City Utah USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesca L.","family":"Facco","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2010Fetal Medicine Department of Obstetrics, Gynecology, and Reproductive Sciences University of Pittsburgh School of Medicine  Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan","family":"Redline","sequence":"additional","affiliation":[{"name":"Division of Sleep and Circadian Disorders Departments of Medicine and Neurology Brigham and Women's Hospital, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert C.","family":"Basner","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Allergy and Critical Care Medicine Department of Medicine Columbia University Vagelos College of Physicians and Surgeons  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Judette M.","family":"Louis","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2010Fetal Medicine Department of Obstetrics and Gynecology University of South Florida Morsani College of Medicine  Tampa Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grace W.","family":"Pien","sequence":"additional","affiliation":[{"name":"Division of Sleep Medicine Department of Medicine University of Pennsylvania Perelman School of Medicine  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alice","family":"Sherman\u2010Brown","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2010Fetal Medicine Department of Obstetrics and Gynecology University of California\u2010Irvine School of 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