Sympathetic Nervous System Regulation in Pregnancy Disorders
Summary
The sympathetic nervous system (SNS) plays a pivotal role in cardiovascular adaptation throughout pregnancy, balancing the increased metabolic demands of the mother and foetus. In healthy gestation, SNS activity progressively rises, yet compensatory vasodilatory and volume-expanding mechanisms maintain normotension. By contrast, hypertensive pregnancy disorders such as gestational hypertension and pre-eclampsia are characterised by maladaptive SNS regulation, leading to elevated peripheral resistance, endothelial dysfunction and end-organ compromise. Recent work has elucidated how altered neurotransmitter release, receptor sensitivity and central autonomic integration contribute to the pathogenesis of these conditions. Moreover, studies of specific neuromodulators and reflex pathways have revealed potential biomarkers and therapeutic targets. An improved understanding of the interplay between sympathoexcitation, vascular reactivity and hormonal modulation is essential for early detection, risk stratification and management of pregnancy-related hypertensive disorders on a global scale.
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Sympathetic Nervous System Regulation in Pregnancy Disorders publication trend
The graph below shows the total number of articles in sympathetic nervous system regulation in pregnancy disorders across all publications each year (not limited to Nature Index journals).
Technical terms
Muscle sympathetic nerve activity (MSNA): A direct microneurographic measure of efferent sympathetic signals to skeletal muscle blood vessels, expressed as burst frequency or incidence.
Catestatin: A peptide fragment derived from chromogranin A that inhibits catecholamine release and modulates vascular tone.
Baroreflex sensitivity: The responsiveness of autonomic reflex pathways that adjust heart rate and vascular resistance in response to blood pressure changes.
Sympathoexcitation: Heightened activity of the sympathetic nervous system, often manifesting as increased heart rate, vasoconstriction and elevated blood pressure.
References
- Analysis of Circulating Catestatin in Early Pregnancy: A Preliminary Investigation. Biomedicines (2024).
- Muscle sympathetic nerve activity during pregnancy: A systematic review and meta‐analysis. Physiological Reports (2023).
- The sympathetic nervous system in healthy and hypertensive pregnancies: physiology or pathology?. Quarterly Journal of Experimental Physiology and Cognate Medical Sciences (2022).
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