Abstract
Major adaptations occur in the maternal cardiovascular system during pregnancy and after delivery; knowledge of these changes is essential to the health management of pregnant women. This paper presents a longitudinal study and proposes a methodology to monitor daily pulse rates (PRs) and characterize the weekly changes in maternal PRs before and after delivery. PRs were recorded during nightly sleep using an automatic monitoring system. PRs of the nonpregnant woman were taken as a reference. Weekly PR properties were characterized by histogram and a two-Gaussian mixture model. A coupling use of sample entropy and pulse rate was applied to cluster the stages during recovery period after delivery. Results depicted a profile of individual’s cardiac recovery process in late pregnancy and after delivery. The results reveal that maternal PRs show different patterns in various stages of recovery. Later stages of recovery seemed to require a much longer period. The present study introduced a convenient approach in long-term maternal cardiac condition monitoring.
Highlights
The maternal cardiovascular system undergoes remarkable changes during pregnancy before and after delivery to meet the increased metabolic demands of pregnancy [1,2,3,4,5]
There was a significant increase in pulse rates (PRs) mean level on the 37th week postpartum. Another notable decrease in the PR happened on the 55th week postpartum, accompanied by a reduction in the standard deviation (SD)
Both daily and weekly PR dynamics of the nonpregnant control subject remained stable throughout the recording period, with only small variations
Summary
The maternal cardiovascular system undergoes remarkable changes during pregnancy before and after delivery to meet the increased metabolic demands of pregnancy [1,2,3,4,5]. Recent laboratory studies have reported some specific turning points during restoration when significant changes of cardiac dynamics can be observed [1,2,3, 6,7,8,9]. Heart rate (HR) was reported to return slowly to baseline levels by 2–6 weeks postpartum in some studies [1, 2, 6, 9,10,11]. There has been concern that the changes in cardiac function associated with pregnancy might not return to prepregnancy levels [8, 9, 11]. Apart from cardiac adaptation, postpartum recovery can be influenced by many other factors, such as physical and age differences, mode of delivery, sufficient rest, appropriate exercise, and ample supplies of nutrients. If sympathetic-predominant autonomic balance is not smoothly recovered, postpartum women might become vulnerable to external stressors and may develop mental disorders which can inversely postpone the cardiac recovery [12,13,14]
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