A Cross-Sectional Analysis of Maternal Cardiac Autonomic Function in Kazakh Pregnant Women with Gestational Diabetes

Aigul Sartayeva,1 Khatima Kudabayeva,2 Nurgul Abenova,3 Yerlan Bazargaliyev,2 Laura Danyarova,4 Gulnaz Adilova,5 Aliya Zhylkybekova,6 Amin Tamadon7 1Department of General Medical Practice No. 2, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan; 2Department of Internal Diseases No. 1, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan; 3Department of General Medical Practice No. 1, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan; 4Department of Endocrinology, Research Institute of Cardiology and Internal Diseases, Almaty, Kazakhstan; 5Department of Obstetrics and Gynecology No. 2, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan; 6Department of Pathophysiology, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan; 7Department of Natural Sciences, West Kazakhstan Marat Ospanov Medical University, Aktobe, KazakhstanCorrespondence: Aigul Sartayeva, Email [email protected] Amin Tamadon, Email [email protected]: Gestational diabetes mellitus (GDM) is a common complication during pregnancy that poses considerable risks to both maternal and fetal health. However, its effect on cardiac autonomic function, measured by heart rate variability (HRV), remains uncertain. This study aims to investigate potential alterations in cardiac autonomic function in women diagnosed with GDM.Methods: In this cross-sectional study, 80 Kazakh pregnant women in their third trimester with GDM were enrolled from the endocrinology department of Aktobe Medical Center between January and April 2023. A control group of 30 third-trimester pregnant women without GDM was also selected from outpatient clinics in Aktobe City. HRV was measured with participants in a seated position. A nomogram was developed to predict GDM risk, integrating relevant parameters associated with the condition.Results: Women with GDM were found to be older than those in the control group (p=0.005), though there were no significant differences in education level, employment status, or parity between the two groups. GDM was associated with larger fetal size (p=0.035) and a higher incidence of miscarriages and abortions (p< 0.05) compared to the control group. Additionally, obesity was more prevalent among women with GDM (p< 0.05). HRV parameters showed no significant differences between the GDM group and healthy pregnant women. The nomogram demonstrated good predictive accuracy, with an area under the curve of 0.7847 in the training cohort.Conclusion: The nomogram developed in this study may prove useful for clinicians and patients in making informed clinical decisions and assessing outcomes. Notably, no significant differences in HRV were observed between women with uncomplicated pregnancies and those with GDM.Keywords: diabetes, gestational, heart rate, Kazakh people, hyperglycemia