Effect of Pregnancy on Postural Tachycardia Syndrome
Open accessAbstract
Objectives To compare the clinical presentation, autonomic dysfunction, and pregnancy outcomes in parous and nulliparous women with postural tachycardia syndrome (POTS) and in women with POTS before and after pregnancy.Patients and methods This study consists of women who had at least 1 pregnancy during which time they met criteria for POTS between May 1993 and July 2009. All patients underwent standard autonomic testing. POTS was defined as a heart rate (HR) increase of greater than 30 beats/min on head-up tilt (HUT) with symptoms of orthostatic intolerance. Patients' charts were reviewed retrospectively to determine pregnancy outcomes.Results Clinical characteristics related to POTS did not differ between parous and nulliparous women except for disease duration (parous, 3.7+/-2.6; nulliparous, 2.1+/-2.2; P<.001). Autonomic dysfunction did not differ between groups (change in HR on HUT: parous, 42.6+/-12.0 beats/min; nulliparous, 41.3+/-10.6 beats/min; P=.39). Of 116 total pregnancies, adverse pregnancy outcomes were reported in 9% and maternal complications in 1%. No complication was related to POTS. There was a trend toward modest improvement in autonomic dysfunction before and after pregnancy (change in HR on HUT: before pregnancy, 38.1+/-22.7 beats/min; after pregnancy, 21.9+/-14.9 beats/min; P=.07).Conclusion The long-term impact of pregnancy on POTS does not appear to be clinically important. However, there does appear to be a trend toward improvement in the short-term postpartum period. Adverse pregnancy events were similar to those seen in the general public and do not present a barrier to women with POTS who want to have children.
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The lack of a significant difference in lightheadedness during pregnancy might be due to the increase in blood volume.
“This lack of a significant difference in lightheadedness during pregnancy might be due to the increase in blood volume [23], a hypothesis shared by Kimpinski et al. [22].”
From Gynecologic disorders and menstrual cycle lightheadedness in postural tachycardia syndrome (2012) · cites this paper as [22]
In the discussion section (page unavailable), Kimpinski et al. suggest that increased blood and plasma volume during pregnancy may explain a trend toward improved orthostatic intolerance in the second and third trimesters. They also report no statistically significant difference in orthostatic-intolerance scores across trimesters, but they do not report a separate result for lightheadedness or specifically explain its lack of a significant difference. (LLM, conf=0.84)
Experimental — accuracy not yet measuredExperiencing pregnancy was not associated with significant changes in symptom burden.
“Experiencing pregnancy was not associated with significant changes in symptom burden (Kimpinski et al., 2010”
From Self-reported symptom burden in postural orthostatic tachycardia syndrome (POTS): A narrative review of observational and interventional studies (2023) · cites this paper as Kimpinski et al., 2010
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- Authors
- Kimpinski, K., Iodice, V., Sandroni, P., & Low, P. A.
- Affiliations
- Mayo Clinic (US)
- Corresponding author
- Low, Phillip A.
- Venue
- Mayo Clinic Proceedings
- Publisher
- Elsevier BV
- Published
- 2010-07
- Volume
- 85
- Issue
- 7
- Pages
- 639-644
- ISSN
- 0025-6196 (ISSN-L)
- PMC
- PMC2894719
- OpenAlex
- W2087166987
- Cited by
- 21
- References
- 21
- Citations by year
- 2023: 2 · 2022: 4 · 2021: 1 · 2020: 1 · 2019: 2 · 2018: 5 · 2015: 2 · 2012: 4
- FWCI
- 1.35
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Mayo Clinic Proceedings (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Georgia Clinical and Translational Science Alliance
- National Institutes of Health (n01ns032352-003, NS4 4233, NS4 3364, NS3 2352, RR24150)
- National Institute of Neurological Disorders and Stroke (P01NS044233, NS-44233, N01 NS032352, NS22352, R01NS022352, NS4 3364, S11NS043364)
- National Center for Research Resources (UL1RR24150, UL1RR024150)
- Topics
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Issues in Pregnancy
- Keywords
- postural orthostatic tachycardia syndrome, pregnancy, autonomic dysfunction, orthostatic intolerance, parous women, nulliparous women, pregnancy outcomes, postpartum period, head-up tilt, heart rate
- MeSH terms
- Abortion, Spontaneous, Adult, Analysis of Variance, Female, Heart Rate, Humans, Maternal Age, Minnesota, Parity, Pregnancy, Pregnancy Complications, Pregnancy Outcome, Pregnancy Trimester, Second, Pregnancy Trimester, Third, Retrospective Studies, Risk Factors, Severity of Illness Index, Tilt-Table Test, Statistics, Nonparametric, Postural Orthostatic Tachycardia Syndrome
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