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Clinical Autonomic Research
Erschienen in: Clinical Autonomic Research 4/2008

01.08.2008 | RESEARCH ARTICLE

The effect of depression on heart rate variability during pregnancy

A naturalistic study

verfasst von: Alison K. Shea, MSc, PhD, Markad V. Kamath, PhD, Alison Fleming, PhD, David L. Streiner, PhD, Keith Redmond, B. Eng, Meir Steiner, MD, PhD, FRCPC

Erschienen in: Clinical Autonomic Research | Ausgabe 4/2008

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Abstract

Depression during pregnancy has been associated with a number of adverse outcomes, but the underlying physiological mechanisms involved remain unclear. The purpose of this study was to examine the effects of maternal depression during pregnancy on the autonomic modulation of heart rate, in a naturalistic setting. Eighty-one pregnant women were studied between 25 and 31 weeks of gestation and were identified as either Depressed (n = 46), or healthy, Control (n = 35), based on depression scores and lifetime psychiatric history. Subjects wore a 24-h Holter recorder to measure time-domain and frequency-domain of heart rate variability (HRV). Pregnant women in the Depressed Group had significantly reduced time-domain measures: standard deviation of all 24-h NN intervals (SDNN) and the standard deviation of the averages of NN intervals in all 5-min segments of the entire recording (SDANN) (P = 0.013, 0.016, respectively), as well as higher heart rates while asleep (P = 0.028), compared to Controls, after controlling for age, smoking, and antidepressant (AD) medication. The low frequency/high frequency (LF/HF) ratio during the sleeping hours was associated with higher depression scores (R = 0.24; P = 0.041). HRV measures improved in women taking AD medication. The autonomic nervous system may be affected in women experiencing depression during pregnancy, indicating a possible decreased parasympathetic (vagal) influence. Women taking AD medication showed some improvement in HRV measures. These data suggest that psychophysiological changes occur in women experiencing depression during pregnancy.
Literatur
1.
Agelink MW, Boz C, Ullrich H, Andrich J (2002) Relationship between major depression and heart rate variability. Clinical consequences and implications for antidepressive treatment. Psychiatry Res 113:139–149PubMedCrossRef
2.
Akselrod S, Barak Y, Ben-Dov Y, Keselbrener L, Baharav A (2001) Estimation of autonomic response based on individually determined time axis. Auton Neurosci 90:13–23PubMedCrossRef
3.
Andersson L, Sundstrom-Poromaa I, Wulff M, Astrom M, Bixo M (2006) Depression and anxiety during pregnancy and 6 months postpartum: a follow-up study. Acta Obstet Gynecol Scand 85:937–944PubMed
4.
Andersson L, Sundstrom-Poromaa I, Wulff M, Astrom M, Bixo M (2004) Neonatal outcome following maternal antenatal depression and anxiety: a population-based study. Am J Epidemiol 159:872–881PubMedCrossRef
5.
Antonazzo P, Cetin I, Tarricone D, Lombardi F, Pardi G (2004) Cardiac autonomic modulation in normal, high-risk, and in vitro fertilization pregnancies during the first trimester. Am J Obstet Gynecol 190:199–205PubMedCrossRef
6.
Avery ND, Wolfe LA, Amara CE, Davies GA, McGrath MJ (2001) Effects of human pregnancy on cardiac autonomic function above and below the ventilatory threshold. J Appl Physiol 90:321–328PubMed
7.
Bar KJ, Greiner W, Jochum T, Friedrich M, Wagner G, Sauer H (2004) The influence of major depression and its treatment on heart rate variability and pupillary light reflex parameters. J Affect Disord 82:245–252PubMedCrossRef
8.
Bonnemeier H, Richardt G, Potratz J, Wiegand UK, Brandes A, Kluge N, Katus HA (2003) Circadian profile of cardiac autonomic nervous modulation in healthy subjects: differing effects of aging and gender on heart rate variability. J Cardiovasc Electrophysiol 14:791–799PubMedCrossRef
9.
Carney RM, Freedland KE, Stein PK, Skala JA, Hoffman P, Jaffe AS (2000) Change in heart rate and heart rate variability during treatment for depression in patients with coronary heart disease. Psychosom Med 62:639–647PubMed
10.
Carrington M, Walsh M, Stambas T, Kleiman J, Trinder J (2003) The influence of sleep onset on the diurnal variation in cardiac activity and cardiac control. J Sleep Res 12:213–221PubMedCrossRef
11.
Cox J, Holden JM, Sagovsky R (1987) Detection of postnatal depression. Development of the 10-item Edinburgh postnatal depression scale 150:782–786
12.
Davidson J, Watkins L, Owens M, Krulewicz S, Connor K, Carpenter D, Krishnan R, Nemeroff C (2005) Effects of paroxetine and venlafaxine XR on heart rate variability in depression. J Clin Psychopharmacol 25:480–484PubMedCrossRef
13.
Davydov DM, Shapiro D, Cook IA, Goldstein I (2006) Baroreflex mechanisms in major depression. Prog Neuropsychopharmacol Biol Psychiatry 31:164–177PubMedCrossRef
14.
Dieter JN, Field T, Hernandez-Reif M, Jones NA, Lecanuet JP, Salman FA, Redzepi M (2001) Maternal depression and increased fetal activity. J Obstet Gynaecol 21:468–473PubMedCrossRef
15.
DiPietro JA, Costigan KA, Pressman EK, Doussard-Roosevelt JA (2000) Antenatal origins of individual differences in heart rate. Dev Psychobiol 37:221–228PubMedCrossRef
16.
Faisal-Cury A, Rossi Menezes P (2007) Prevalence of anxiety and depression during pregnancy in a private setting sample. Arch Womens Ment Health 10:25–32PubMedCrossRef
17.
Felber Dietrich D, Schwartz J, Schindler C, Gaspoz JM, Barthelemy JC, Tschopp JM, Roche F, von Eckardstein A, Brandli O, Leuenberger P, Gold DR, Ackermann-Liebrich U (2007) Effects of passive smoking on heart rate variability, heart rate and blood pressure: an observational study. Int J Epidemiol 36:834–840
18.
Field T, Diego M, Hernandez-Reif M, Schanberg S, Kuhn C, Yando R, Bendell D (2003) Pregnancy anxiety and comorbid depression and anger: effects on the fetus and neonate. Depress Anxiety 17:140–151PubMedCrossRef
19.
Gillespie CF, Nemeroff CB (2005) Hypercortisolemia and depression. Psychosom Med 67(Suppl 1):S26–S28PubMedCrossRef
20.
Glassman AH, Bigger JT, Gaffney M, Van Zyl LT (2007) Heart rate variability in acute coronary syndrome patients with major depression: influence of sertraline and mood improvement. Arch Gen Psychiatry 64:1025–1031PubMedCrossRef
21.
Hughes JW, Stoney CM (2000) Depressed mood is related to high-frequency heart rate variability during stressors. Psychosom Med 62:796–803PubMed
22.
Hughes JW, Watkins L, Blumenthal JA, Kuhn C, Sherwood A (2004) Depression and anxiety symptoms are related to increased 24-h urinary norepinephrine excretion among healthy middle-aged women. J Psychosom Res 57:353–358PubMed
23.
James GD, Berge-Landry Hv H, Valdimarsdottir HB, Montgomery GH, Bovbjerg DH (2004) Urinary catecholamine levels in daily life are elevated in women at familial risk of breast cancer. Psychoneuroendocrinology 29:831–838PubMedCrossRef
24.
Jayawardana MA (2001) Baroreceptor sensitivity and haemodynamics in normal pregnancy. J Obstet Gynaecol 21:559–562PubMedCrossRef
25.
Kaaja RJ, Moore MP, Yandle TG, Ylikorkala O, Frampton CM, Nicholls MG (1999) Blood pressure and vasoactive hormones in mild preeclampsia and normal pregnancy. Hypertens Pregnancy 18:173–187PubMedCrossRef
26.
Kurki T, Hiilesmaa V, Raitasalo R, Mattila H, Ylikorkala O (2000) Depression and anxiety in early pregnancy and risk for preeclampsia. Obstet Gynecol 95:487–490PubMedCrossRef
27.
Landen M, Wennerblom B, Tygesen H, Modigh K, Sorvik K, Ysander C, Ekman A, Nissbrandt H, Olsson M, Eriksson E (2004) Heart rate variability in premenstrual dysphoric disorder. Psychoneuroendocrinology 29:733–740PubMedCrossRef
28.
Lechin F, van der Dijs B, Orozco B, Lechin ME, Baez S, Lechin AE, Rada I, Acosta E, Arocha L, Jimenez V, et al (1995) Plasma neurotransmitters, blood pressure, and heart rate during supine-resting, orthostasis, and moderate exercise conditions in major depressed patients. Biol Psychiatry 38:166–173PubMedCrossRef
29.
Levine RE, Oandasan AP, Primeau LA, Berenson AB (2003) Anxiety disorders during pregnancy and postpartum. Am J Perinatol 20:239–248PubMedCrossRef
30.
Lunshof S, Boer K, Wolf H, van Hoffen G, Bayram N, Mirmiran M (1998) Fetal and maternal diurnal rhythms during the third trimester of normal pregnancy: outcomes of computerized analysis of continuous twenty-four-hour fetal heart rate recordings. Am J Obstet Gynecol 178:247–254PubMedCrossRef
31.
Malik M (1996) Heart rate variability. Standards of measurement, physiological interpretation, and clinical use. Task force of the European Society of Cardiology and the North American Society of pacing and electrophysiology. Eur Heart J pp 354–381
32.
Manyonda IT, Slater DM, Fenske C, Hole D, Choy MY, Wilson C (1998) A role for noradrenaline in pre-eclampsia: towards a unifying hypothesis for the pathophysiology. Br J Obstet Gynaecol 105:641–648PubMed
33.
Matthey S, Henshaw C, Elliott S, Barnett B (2006) Variability in use of cut-off scores and formats on the Edinburgh postnatal depression scale: implications for clinical and research practice. Arch Womens Ment Health 9:309–315PubMedCrossRef
34.
McFarlane A, Kamath MV, Fallen EL, Malcolm V, Cherian F, GN (2001) Effect of sertraline on the recovery rate of cardiac autonomic function in depressed patients after acute myocardial infarction. Am Heart J 142:617–623
35.
Metsaars WP, Ganzevoort W, Karemaker JM, Rang S, Wolf H (2006) Increased sympathetic activity present in early hypertensive pregnancy is not lowered by plasma volume expansion. Hypertens Pregnancy 25:143–157PubMedCrossRef
36.
Mittmann N, Mitter S, Borden EK, Herrmann N, Naranjo CA, Shear NH (1997) Montgomery-Asberg severity gradations. Am J Psychiatry 154:1320–1321PubMed
37.
Ophir E, Dourleshter G, Hirsh Y, Fait V, German L, Bornstein J (2006) Newborns of pre-eclamptic women: a biochemical difference present in utero. Acta Obstet Gynecol Scand 85:1172–1178PubMedCrossRef
38.
Paarlberg KM, Vingerhoets AJ, Passchier J, Dekker GA, Heinen AG, van Geijn HP (1999) Psychosocial predictors of low birthweight: a prospective study. Br J Obstet Gynaecol 106:834–841PubMed
39.
40.
Porges SW (1995) Cardiac vagal tone: a physiological index of stress. Neurosci Biobehav Rev 19:225–233PubMedCrossRef
41.
Rondo PH, Ferreira RF, Nogueira F, Ribeiro MC, Lobert H, Artes R (2003) Maternal psychological stress and distress as predictors of low birth weight, prematurity and intrauterine growth retardation. Eur J Clin Nutr 57:266–272PubMedCrossRef
42.
Sevy S, Papadimitriou GN, Surmont DW, Goldman S, Mendlewicz J (1989) Noradrenergic function in generalized anxiety disorder, major depressive disorder, and healthy subjects. Biol Psychiatry 25:141–152PubMedCrossRef
43.
Sheehan D, Lecrubier Y, Sheehan HK (1997) The validity of the mini international neuropsychiatric interview (MINI) according to the SCID-P and its reliability. Eur Psychiatry 12:232–241CrossRef
44.
Sjostrom K, Valentin L, Thelin T, Marsal K (1997) Maternal anxiety in late pregnancy and fetal hemodynamics. Eur J Obstet Gynecol Reprod Biol 74:149–155PubMedCrossRef
45.
Speranza G., Verlato G, Albiero A (1998) Autonomic changes during pregnancy: assessment by spectral heart rate variability analysis. J Electrocardiol 31:101–109PubMedCrossRef
46.
Spielberger CD (1996) State-trait anger expression inventory: professional manual. Psychological Assessment Resources, Odessa
47.
Stein PK, Bosner MS, Kleiger RE, Conger BM (1994) Heart rate variability: a measure of cardiac autonomic tone. Am Heart J 127:1376–1381PubMedCrossRef
48.
Stein PK, Hagley MT, Cole PL, Domitrovich PP, Kleiger RE, Rottman JN (1999) Changes in 24-h heart rate variability during normal pregnancy. Am J Obstet Gynecol 180:978–985PubMedCrossRef
49.
Takase B, Akima T, Satomura K, Ohsuzu F, Mastui T, Ishihara M, Kurita A (2004) Effects of chronic sleep deprivation on autonomic activity by examining heart rate variability, plasma catecholamine, and intracellular magnesium levels. Biomed Pharmacother 58(Suppl 1):S35–S39PubMedCrossRef
50.
Teixeira JM, Fisk NM, Glover V (1999) Association between maternal anxiety in pregnancy and increased uterine artery resistance index: cohort based study. BMJ 318:153–157PubMed
51.
Tucker P, Adamson P, Miranda R Jr, Scarborough A, Williams D, Groff J, McLean H (1997) Paroxetine increases heart rate variability in panic disorder. J Clin Psychopharmacol 17:370–376PubMedCrossRef
52.
Vallejo M, Marquez MF, Borja-Aburto VH, Cardenas M, Hermosillo AG (2005) Age, body mass index, and menstrual cycle influence young women’s heart rate variability—a multivariable analysis. Clin Auton Res 15:292–298PubMedCrossRef
53.
van Amelsvoort LG, Schouten EG, Maan AC, Swenne CA, Kok FJ (2000) Occupational determinants of heart rate variability. Int Arch Occup Environ Health 73:255–262PubMedCrossRef
54.
Wadhwa PD (2005) Psychoneuroendocrine processes in human pregnancy influence fetal development and health. Psychoneuroendocrinology 30:724–743PubMedCrossRef
55.
Walther T, Wessel N, Malberg H, Voss A, Stephan H, Faber R (2006) A combined technique for predicting pre-eclampsia: concurrent measurement of uterine perfusion and analysis of heart rate and blood pressure variability. J Hypertens 24:747–750
56.
Yang CC, Chao TC, Kuo TB, Yin CS, Chen HI (2000) Preeclamptic pregnancy is associated with increased sympathetic and decreased parasympathetic control of HR. Am J Physiol Heart Circ Physiol 278:H1269–H1273PubMed
57.
Yeragani VK, Rao KA, Smitha MR, Pohl RB, Balon R, Srinivasan K (2002) Diminished chaos of heart rate time series in patients with major depression. Biol Psychiatry 51:733–744PubMedCrossRef
Metadaten
Titel
The effect of depression on heart rate variability during pregnancy
A naturalistic study
verfasst von
Alison K. Shea, MSc, PhD
Markad V. Kamath, PhD
Alison Fleming, PhD
David L. Streiner, PhD
Keith Redmond, B. Eng
Meir Steiner, MD, PhD, FRCPC
Publikationsdatum
01.08.2008
Verlag
D. Steinkopff-Verlag
Erschienen in
Clinical Autonomic Research / Ausgabe 4/2008
Print ISSN: 0959-9851
Elektronische ISSN: 1619-1560
DOI
https://doi.org/10.1007/s10286-008-0480-1

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