Maternal and fetal heart rate variability in patients with gestational diabetes mellitus
https://doi.org/10.23946/2500-0764-2026-11-2-58-66
Abstract
Aim. To study regulatory processes in the maternal-placental-fetal system in gestational diabetes mellitus to identify differences in their nature depending on the development of fetal macrosomia.
Materials and Methods. A study of heart rate variability was conducted using standard maternal-fetal methods in 100 women and their fetuses diagnosed with gestational diabetes mellitus and macrosomia detected by ultrasound at 28−29 weeks of pregnancy. The second group consisted of 100 women diagnosed with gestational diabetes mellitus but without macrosomia, according to ultrasound at 28−29 weeks of pregnancy.
Results. The study demonstrates fundamentally different patterns of adaptation in pregnant women with gestational diabetes depending on the development of macrosomia. A favorable scenario (without macrosomia): the body demonstrates effective adaptation – it responds adequately to stress, recovers quickly, and maintains a high energy potential. This indicates intact reserves of the regulatory system. An unfavorable scenario (with macrosomia): despite hyperadaptive efforts, regulation shifts toward autonomous mechanisms (more primitive and energy-consuming). Low energy status, inadequate responses to stress, and lack of recovery indicate a critical decline in adaptive potential. This creates a risk of decompensation and pregnancy complications. Fetuses without macrosomia exhibit a predominantly hyperadaptive state with an optimal balance of autonomic regulation (the ratio of sympathetic to parasympathetic influences is approximately 3:1), high heart rate variability, and rapid adaptation to stress, reflecting significant adaptive potential. With the development of macrosomia in the setting of gestational diabetes, compensatory mechanisms fail: adaptive reserves are suppressed, autonomic regulation is disrupted, and the dominance of the central component of regulation indicates overstrain of the fetal regulatory systems.
Conclusion. The study highlights the negative impact of macrosomia on the functional state of the mother's regulatory systems and points to the need to develop specific rehabilitation measures for women with this complication of gestational diabetes.
About the Authors
O. N. Novikova
Kemerovo State Medical University
Russian Federation
Russian Federation
Dr. Oxana N. Novikova, Dr. Sci (Medicine), associate Professor of the Department of Obstetrics and Gynecology named after Professor G.A. Ushakova
Voroshilova Street, 22A, Kemerovo, 650056
O. V. Glazovskaya
Municipal Clinical Hospital No. 15 named after O.M. Filatov Moscow Department of Health, Women's Health Center on Perervinsky
Russian Federation
Russian Federation
Dr. Olga V. Glazovskaya, MD, obstetrician-gynecologist of the obstetrics and gynecology department №
4, Building 2, Moscow, 109451
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Review
For citations:
Novikova O.N., Glazovskaya O.V. Maternal and fetal heart rate variability in patients with gestational diabetes mellitus. Fundamental and Clinical Medicine. 2026;11(2):58-66. (In Russ.) https://doi.org/10.23946/2500-0764-2026-11-2-58-66
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