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Muscle sympathetic nerve activity during pregnancy: A systematic review and meta‐analysis

We conducted a systematic review and meta‐analysis to quantify the impact of healthy and complex pregnancy on muscle sympathetic nerve activity (MSNA) at rest, and in response to stress. Structured searches of electronic databases were performed until February 23, 2022. All study designs (except rev...

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Autores principales: Greenwall, Kelly M., Brislane, Áine, Matenchuk, Brittany A., Sivak, Allison, Davenport, Margie H., Steinback, Craig D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10006587/
https://www.ncbi.nlm.nih.gov/pubmed/36905144
http://dx.doi.org/10.14814/phy2.15626
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author Greenwall, Kelly M.
Brislane, Áine
Matenchuk, Brittany A.
Sivak, Allison
Davenport, Margie H.
Steinback, Craig D.
author_facet Greenwall, Kelly M.
Brislane, Áine
Matenchuk, Brittany A.
Sivak, Allison
Davenport, Margie H.
Steinback, Craig D.
author_sort Greenwall, Kelly M.
collection PubMed
description We conducted a systematic review and meta‐analysis to quantify the impact of healthy and complex pregnancy on muscle sympathetic nerve activity (MSNA) at rest, and in response to stress. Structured searches of electronic databases were performed until February 23, 2022. All study designs (except reviews) were included: population (pregnant individuals); exposures (healthy and complicated pregnancy with direct measures of MSNA); comparator (individuals who were not pregnant, or with uncomplicated pregnancy); and outcomes (MSNA, BP, and heart rate). Twenty‐seven studies (N = 807) were included. MSNA burst frequency was higher in pregnancy (n = 201) versus non‐pregnant controls (n = 194) (Mean Differences [MD], MD: 10.6 bursts/min; 95% CI: 7.2, 14.0; I (2) = 72%). Accounting for the normative increase in heart rate with gestation, burst incidence was also higher during pregnancy (Pregnant N = 189, non‐pregnant N = 173; MD: 11 bpm; 95% CI: 8, 13 bpm; I (2) = 47%; p < 0.0001). Meta‐regression analyses confirmed that although sympathetic burst frequency and incidence are augmented during pregnancy, this was not significantly associated with gestational age. Compared to uncomplicated pregnancy, individuals with obesity, obstructive sleep apnea, and gestational hypertension exhibited sympathetic hyperactivity, while individuals with gestational diabetes mellitus or preeclampsia did not. Uncomplicated pregnancies exhibited a lesser response to head‐up tilt, but an exaggerated sympathetic responsiveness to cold pressor stress compared to non‐pregnant individuals. MSNA is higher in pregnant individuals and further increased with some, but not all pregnancy complications. PROSPERO registration number: CRD42022311590.
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spelling pubmed-100065872023-03-12 Muscle sympathetic nerve activity during pregnancy: A systematic review and meta‐analysis Greenwall, Kelly M. Brislane, Áine Matenchuk, Brittany A. Sivak, Allison Davenport, Margie H. Steinback, Craig D. Physiol Rep Original Articles We conducted a systematic review and meta‐analysis to quantify the impact of healthy and complex pregnancy on muscle sympathetic nerve activity (MSNA) at rest, and in response to stress. Structured searches of electronic databases were performed until February 23, 2022. All study designs (except reviews) were included: population (pregnant individuals); exposures (healthy and complicated pregnancy with direct measures of MSNA); comparator (individuals who were not pregnant, or with uncomplicated pregnancy); and outcomes (MSNA, BP, and heart rate). Twenty‐seven studies (N = 807) were included. MSNA burst frequency was higher in pregnancy (n = 201) versus non‐pregnant controls (n = 194) (Mean Differences [MD], MD: 10.6 bursts/min; 95% CI: 7.2, 14.0; I (2) = 72%). Accounting for the normative increase in heart rate with gestation, burst incidence was also higher during pregnancy (Pregnant N = 189, non‐pregnant N = 173; MD: 11 bpm; 95% CI: 8, 13 bpm; I (2) = 47%; p < 0.0001). Meta‐regression analyses confirmed that although sympathetic burst frequency and incidence are augmented during pregnancy, this was not significantly associated with gestational age. Compared to uncomplicated pregnancy, individuals with obesity, obstructive sleep apnea, and gestational hypertension exhibited sympathetic hyperactivity, while individuals with gestational diabetes mellitus or preeclampsia did not. Uncomplicated pregnancies exhibited a lesser response to head‐up tilt, but an exaggerated sympathetic responsiveness to cold pressor stress compared to non‐pregnant individuals. MSNA is higher in pregnant individuals and further increased with some, but not all pregnancy complications. PROSPERO registration number: CRD42022311590. John Wiley and Sons Inc. 2023-03-10 /pmc/articles/PMC10006587/ /pubmed/36905144 http://dx.doi.org/10.14814/phy2.15626 Text en © 2023 The Authors. Physiological Reports published by Wiley Periodicals LLC on behalf of The Physiological Society and the American Physiological Society. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Articles
Greenwall, Kelly M.
Brislane, Áine
Matenchuk, Brittany A.
Sivak, Allison
Davenport, Margie H.
Steinback, Craig D.
Muscle sympathetic nerve activity during pregnancy: A systematic review and meta‐analysis
title Muscle sympathetic nerve activity during pregnancy: A systematic review and meta‐analysis
title_full Muscle sympathetic nerve activity during pregnancy: A systematic review and meta‐analysis
title_fullStr Muscle sympathetic nerve activity during pregnancy: A systematic review and meta‐analysis
title_full_unstemmed Muscle sympathetic nerve activity during pregnancy: A systematic review and meta‐analysis
title_short Muscle sympathetic nerve activity during pregnancy: A systematic review and meta‐analysis
title_sort muscle sympathetic nerve activity during pregnancy: a systematic review and meta‐analysis
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10006587/
https://www.ncbi.nlm.nih.gov/pubmed/36905144
http://dx.doi.org/10.14814/phy2.15626
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