Preterm birth, when a baby is born before the 37th week of pregnancy, can lead to significant health and developmental issues. Predicting preterm birth is challenging and current screening options are limited. However, researchers from wearable technology expert WHOOP and West Virginia University have explored whether measuring maternal heart rate variability (HRV) using the WHOOP strap could serve as a digital biomarker for preterm birth.
The WHOOP strap is a wearable device that continuously monitors various physiological parameters, including HRV, which measures the variation in time between consecutive heartbeats. By analyzing data from this device, previous research discovered that maternal HRV decreases during pregnancy until around 33 weeks of gestation before increasing again. However, this research only focused on pregnancies carried to term.
In a recent study published in PLoS ONE, led by Emily Capodilupo from WHOOP, the researchers examined both term and preterm pregnancies to determine if the same HRV trends were observed. The objective was to establish whether changes in HRV could indicate time to delivery or if they were simply related to gestational age.
The study involved 241 women who gave birth between March 2021 and October 2022. They all wore a WHOOP strap throughout their pregnancy, providing an average of 99.9 days of data from week 24 until delivery. The researchers analyzed weekly averages of HRV values derived from measurements taken at 30-second intervals during the night to track trends over time. Two mixed-effect spline models were used to analyze the data: one relating HRV to gestational age and another relating HRV to weeks until birth.
The results showed that while HRV trends were linked to both gestational age and weeks until birth, they were more strongly correlated with weeks until birth for both term and preterm pregnancies. This suggests that monitoring changes in nightly maternal HRV could help identify an increased risk of preterm delivery, prompting further tests and medical interventions when necessary.
According to Capodilupo, the study found that maternal HRV trends inverted seven weeks before delivery, indicating that monitoring this inversion could potentially provide early indication of a probable delivery date. This continuous monitoring using a non-invasive wearable device could be particularly crucial for pregnant women in areas with limited access to medical facilities, as premature births tend to have worse outcomes in these regions.
However, the researchers note that the current dataset is not sufficient for individual-level predictions as the analysis was conducted using average values from each group of women. Capodilupo emphasizes the need for further research with a larger dataset to assess the usefulness of monitoring an inflection point on an individual basis.
Taking this into consideration, the team is now conducting a more extensive investigation into HRV’s potential for predicting preterm birth. Capodilupo states that additional research is needed to better understand this phenomenon at an individual level and determine how accurately an inflection point in maternal vital signs can predict future preterm birth.
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