Sympathetic Overactivity Predicts Microalbuminuria in Pregnancy

• Main Authors: Inder Pal Kaur, Sukanya Gangopadhyay, Kiran Singh, Mamta Tyagi, Gautam Sarkar
• Format: Article
• Language: English
• Published: JCDR Research and Publications Private Limited 2018-12-01
• Series: Journal of Clinical and Diagnostic Research
• Subjects: heart rate variability; pregnancy induced hypertension; sympathetic dominance; urinary albumin creatinine ratio
• Online Access: https://jcdr.net/articles/PDF/12412/36738_CE[Ra1]_F(AC_SL)_PF1(AJ_RK)_PN(SL).pdf

Introduction: Microalbuminuria is a frequent feature in pregnancy, as the latter is a state of haemodynamic changes and sympathetic overactivity. Both sympathetic overactivity {as measured by Heart Rate Variability (HRV)} and microalbuminuria are individually linked with hypertension. So, presence of these conditions in pregnant women could be the reason for the increasing prevalence of Pregnancy Induced Hypertension (PIH)/Preeclampsia. Aim: To measure HRV and urinary microalbumin excretion simultaneously in pregnant women. Materials and Methods: In this hospital-based study, pregnant women in 2nd and 3rd trimester were recruited along with agematched controls. Their sympathetic activity and urinary albumin-creatinine ratio were recorded. The patients were followed till delivery to note progression to preeclampsia/ pregnancy-induced hypertension. Statistical analysis was done with appropriate tests using Graphpad Prizm (version 7.04). Results: The level of urinary microalbumin was found to be high in the pregnant group. Albumin Creatinine Ratio (ACR) was raised in pregnancy (72.35±50.29 in third trimester, 84.48±52.61 in second trimester and 17.59±6.19 in non-pregnant control group; p<0.001). The HRV study shows that sympathetic dominance is more during pregnancy as compared to nonpregnant (2.09±0.91 in pregnant and 1.04±0.65 in non-pregnant group). Conclusion: It was concluded that there is a neurogenic role for the causation of microalbuminuria in pregnancy. As this condition predicts the development of pre-eclampsia/eclampsia in later pregnancy, all the methods targeting generalised stress reduction could be advised to all pregnant women during their first visit.