Heart rate variability in hypertensive pregnancy disorders: a systematic review

S. Moors (Corresponding author), K.J.J. Staaks, M.E.M.H. Westerhuis, L.R.C. Dekker, K.M.J. Verdurmen, S.G. Oei, J.O.E.H. van Laar

Research output: Contribution to journalReview articlepeer-review

22 Citations (Scopus)


BACKGROUND: Hypertensive pregnancy disorders (HPD) are associated with dysfunction of the autonomic nervous system. Cardiac autonomic functions can be assessed by heart rate variability (HRV) measurements.

OBJECTIVE: To study whether HRV detects differences in the function of the autonomic nervous system between pregnant women with HPD compared to normotensive pregnant women and between women with a history of a pregnancy complicated by HPD compared to women with a history of an uncomplicated pregnancy.

METHODS: A systematic search was performed in Medline, EMBASE, and CENTRAL to identify studies comparing HRV between pregnant women with HPD or women with a history of HPD to women with (a history of) normotensive pregnancies.

RESULTS: The search identified 523 articles of which 24 were included in this review, including 850 women with (a history of) HPD and 1205 normotensive controls. The included studies showed a large heterogenicity. A decrease in overall HRV was found in preeclampsia (PE), compared to normotensive pregnant controls. A trend is seen towards increased low frequency/high frequency-ratio in women with PE compared to normotensive pregnant controls.

CONCLUSION: Our systematic review supports the hypothesis a sympathetic overdrive is found in HPD which is associated with a parasympathetic withdrawal. However, the included studies in our review showed a large diversity in the methods applied and their results.

Original languageEnglish
Pages (from-to)56-68
Number of pages13
JournalPregnancy Hypertension
Publication statusPublished - Apr 2020


  • Autonomic nervous system
  • Gestational hypertension
  • Heart rate variability
  • Hypertensive pregnancy disorders
  • Preeclampsia
  • Perinatal Medicine
  • Blood Pressure
  • Autonomic Nervous System/physiopathology
  • Heart Rate
  • Humans
  • Hypertension, Pregnancy-Induced/diagnosis
  • Gestational Age
  • Pregnancy
  • Young Adult
  • Adolescent
  • Adult
  • Female
  • Cardiovascular System/innervation


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