{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T00:31:49Z","timestamp":1792801909059,"version":"4.5.0"},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2024,3,5]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Long\u2010term (visit\u2010to\u2010visit) blood pressure variability (BPV) and heart rate variability (HRV) outside pregnancy are associated with adverse cardiovascular outcomes. Given the limitations of relying solely on blood pressure level to identify pregnancies at risk, long\u2010term (visit\u2010to\u2010visit) BPV or HRV may provide additional diagnostic\/prognostic counsel. To address this, we conducted a systematic review to examine the association between long\u2010term BPV and HRV in pregnancy and adverse maternal and perinatal outcomes.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">Databases were searched from inception to May 2023 for studies including pregnant women, with sufficient blood pressure or heart rate measurements to calculate any chosen measure of BPV or HRV. Studies were excluded that reported short\u2010term, not long\u2010term, variability. Adjusted odds ratios were extracted. Eight studies (138\u2009949 pregnancies) reporting BPV met our inclusion criteria; no study reported HRV and its association with pregnancy outcomes. BPV appeared to be higher in women with hypertension and preeclampsia specifically, compared with unselected pregnancy cohorts. Greater BPV was associated with significantly more adverse pregnancy outcomes, particularly maternal (gestational hypertension [odds ratio range, 1.40\u20132.15], severe hypertension [1.40\u20132.20]), and fetal growth (small\u2010for\u2010gestational\u2010age infants [1.12\u20131.32] or low birth weight [1.18\u20131.39]). These associations were independent of mean blood pressure level. In women with hypertension, there were stronger associations with maternal outcomes but no consistent pattern for perinatal outcomes.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Future work should aim to confirm whether BPV could be useful for risk stratification prospectively in pregnancy, and should determine the optimal management path for those women identified at increased risk of adverse outcomes.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.123.032636","type":"journal-article","created":{"date-parts":[[2024,2,27]],"date-time":"2024-02-27T10:06:03Z","timestamp":1709028363000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":18,"title":["Blood Pressure and Heart Rate Variability and the Impact on Pregnancy Outcomes: A Systematic Review"],"prefix":"10.1161","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6127-8282","authenticated-orcid":false,"given":"Milly G.","family":"Wilson","sequence":"first","affiliation":[{"name":"Department of Women and Children\u2019s Health School of Life Course and Population Health Sciences, Faculty of Medicine, King\u2019s College London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7704-1677","authenticated-orcid":false,"given":"Jeffrey N.","family":"Bone","sequence":"additional","affiliation":[{"name":"British Columbia Children\u2019s Hospital Research Institute, University of British Columbia Vancouver Canada"},{"name":"Department of Obstetrics and Gynaecology University of British Columbia Vancouver Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2564-7348","authenticated-orcid":false,"given":"Hiten D.","family":"Mistry","sequence":"additional","affiliation":[{"name":"Department of Women and Children\u2019s Health School of Life Course and Population Health Sciences, Faculty of Medicine, King\u2019s College London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8425-9359","authenticated-orcid":false,"given":"Laura J.","family":"Slade","sequence":"additional","affiliation":[{"name":"Robinson Research Institute, The University of Adelaide South Australia Australia"},{"name":"Department of Obstetrics and Gynaecology Women\u2019s and Children\u2019s Hospital Adelaide Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7220-4382","authenticated-orcid":false,"given":"Joel","family":"Singer","sequence":"additional","affiliation":[{"name":"School of Population and Public Health University of British Columbia Vancouver Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4136-3070","authenticated-orcid":false,"given":"Peter","family":"von Dadelszen","sequence":"additional","affiliation":[{"name":"Department of Women and Children\u2019s Health School of Life Course and Population Health Sciences, Faculty of Medicine, King\u2019s College London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1355-610X","authenticated-orcid":false,"given":"Laura A.","family":"Magee","sequence":"additional","affiliation":[{"name":"Department of Women and Children\u2019s Health School of Life Course and Population Health Sciences, Faculty of Medicine, King\u2019s College London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.117.006895"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i4098"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2023.01.013"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2022.850223"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-016-0384-4"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.16319"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41440-018-0112-7"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.preghy.2019.09.009"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.preghy.2019.12.002"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41440-020-00544-7"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.120.16851"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41371-021-00580-x"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41440-021-00768-1"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/jch.14500"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j2099"},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2022.10.004"},{"key":"e_1_3_1_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)60235-8"},{"key":"e_1_3_1_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.preghy.2020.03.003"}],"container-title":["Journal of the American Heart 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