To study the characteristics of heart rate rhythm in pregnant women at different trimester of pregnancy, and to explore the relationship between the basic rhythm of heart rate and pregnancy complications. Thirteen pregnant women who were diagnosed with normal early pregnancy in the Reproductive Center of the Second Affiliated Hospital of Soochow University from June 2018 to December 2019 were prospectively selected. Personal files were created and the heart rate data of pregnancy women was collected 24 hours a day by wearable devices until delivery. Prenatal examination and pregnancy outcomes were surveyed at follow-up. The cosine analysis method and the designed statistical module were used to analyze the long-term rhythm of pregnant women's heart rate. The heart rate of pregnant women showed a significant rhythm at different gestational weeks. Compared with the gestational week of 12, the midline-estimating statistic of rhythm(MESOR) increased significantly at the gestational week of 28 and 32 (t=-2.751,P=0.013;t=-2.314,P=0.032).The phase of rhythm shifted from 14∶00 pm in the first trimester of pregnancy (12 weeks) to 16∶00 pm in the second trimester (24 weeks) (t=2.613,P=0.018) and returned to 14∶00 pm at the third trimester (32 weeks) (t=-2.176,P=0.046). Season had no significant effect on the changes of MESOR, amplitude and phase of maternal heart rate in the first trimester (t=-0.356,P=0.729;t=-0.777,P=0.464;t=-0.434,P=0.673), while season had no significant effect on the changes of MESOR, amplitude and phase in the third trimester (t=-0.663,P=0.532;t=-0.209,P=0.841;t=0.625,P=0.592). The heart rate of one pregnant woman with natural delivery had rhythm disorder from the start of labor to delivery. The heart rate of one pregnant woman with premature rupture of membranes showed rhythm disorder before and after the rupture of membranes, and smaller amplitude. Rhythm disturbance may play a suggestive role in preterm delivery and labor initiation. In conclusion, pregnancy may cause changes in the internal heart rate rhythm. Maternal internal rhythm disturbance may occur when delivery or premature rupture of membranes occurs. The heart rate rhythm of pregnant women may be related to some common complications of pregnancy such as premature rupture of membranes.
研究不同孕周孕妇心率呈现的节律变化特征，初步探讨妊娠期女性心率的基本节律变化及与妊娠并发症的相关性。前瞻性选取2018年6月至2019年12月于苏州大学附属第二医院生殖中心确诊正常早期妊娠的13名孕妇，佩戴联合研发的可穿戴设备直至分娩，创建个人档案，收集不同孕周孕妇24 h连续心率数据，随访孕期产检信息及妊娠结局，采用余弦分析法和设计的统计模块进行分析获得孕妇心率的长期节律。结果显示，孕妇心率在不同孕周均显示出显著的时相节律。与妊娠12周相比，妊娠28周、妊娠32周孕妇心率呈现出节律的调整中值（midline-estimating statistic of rhythm，MESOR）明显增加（t=-2.751，P=0.013；t=-2.314，P=0.032），且妊娠早期（妊娠12周）节律的峰值相位位于14∶00左右，妊娠中期（妊娠24周）位于16∶00左右（t=2.613，P=0.018），而妊娠32周相位又前移至14∶00左右（t=-2.176，P=0.046），差异具有统计学意义。季节对妊娠早期孕妇心率的节律参数MESOR、振幅、相位的变化无显著影响（t=-0.356，P=0.729；t=-0.777，P=0.464；t=-0.434，P=0.673）；季节对妊娠晚期孕妇节律参数MESOR、振幅、相位的变化亦无显著影响（t=-0.663，P=0.532；t=-0.209，P=0.841；t=0.625，P=0.592）。1例自然分娩孕妇心率在分娩发动至分娩前出现了节律紊乱；1例胎膜早破孕妇心率在胎膜破裂前后出现了节律紊乱，且振幅变小。节律紊乱可能在早产或分娩发动中起提示作用。综上，妊娠可能会引起机体内在心率的节律发生变化，当分娩发动或发生胎膜早破等疾病时母体可能会出现内在节律紊乱，妊娠女性心率的节律可能与胎膜早破等一些妊娠常见的并发症有相关性。.