***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Fetal exposure to preeclampsia is associated with higher blood pressure and later risk of stroke . We aim ed to investigate the associations of maternal preeclampsia , gestational hypertension , and maternal blood pressure change in pregnancy with offspring cardiac structure and function in adolescence . Methods and Results Using data from a prospect i ve birth cohort study , we included offspring who underwent echocardiography ( mean age , 17.7 years ; SD , 0.3 ; N=1592 ) . We examined whether hypertensive disorders of pregnancy were associated with offspring cardiac structure and systolic/diastolic function using linear regression . Using multilevel linear spline models ( measurement occasions within women ) , we also investigated whether rate of maternal systolic/diastolic blood pressure change during pregnancy ( weeks 8–18 , 18–30 , 30–36 , and 36 or more ) were associated with offspring outcomes . Main models were typically adjusted for maternal age , offspring age and sex , prepregnancy body mass index , parity , glycosuria/diabetes mellitus , education , and maternal smoking . Exposure to maternal preeclampsia ( 0.025 ; 95 % CI , 0.008–0.043 ) and gestational hypertension ( 0.010 ; 0.002–0.017 ) were associated with greater relative wall thickness . Furthermore , preeclampsia was also associated with a smaller left ventricular end‐diastolic volume ( −9.0 mL ; −15 to −3.1 ) . No associations were found between hypertensive disorders of pregnancy and offspring cardiac function . Positive rate of maternal systolic blood pressure change during weeks 8 to 18 was associated with greater offspring left ventricular end‐diastolic volume , left ventricular mass indexed to height2.7 , and E/A. Conclusions Adolescent offspring exposed to maternal preeclampsia had greater relative wall thickness and reduced left ventricular end‐diastolic volume , which could be early signs of concentric remodeling and affect future cardiac function as well as risk of cardiovascular disease BACKGROUND Betamethasone is widely used to enhance fetal lung maturation in case of threatened preterm labour .  Fetal heart rate variability is one of the most important parameters to assess in fetal monitoring , since it is a reliable indicator for fetal distress . AIM To describe the effect of betamethasone on fetal heart rate variability , by applying spectral analysis on non-invasive fetal electrocardiogram recordings . STUDY DESIGN Prospect i ve cohort study . SUBJECTS Patients that require betamethasone , with a gestational age from 24 weeks onwards . OUTCOME MEASURES Fetal heart rate variability parameters on day 1 , 2 , and 3 after betamethasone administration are compared to a reference measurement . RESULTS Following 68 inclusion s , 12 patients remained with complete series of measurements and sufficient data quality . During day 1 , an increase in absolute fetal heart rate variability values was seen . During day 2 , a decrease in these values was seen . All trends indicate to return to pre-medication values on day 3 . Normalised high- and low-frequency power show little changes during the study period . CONCLUSIONS The changes in fetal heart rate variability following betamethasone administration show the same pattern when calculated by spectral analysis of the fetal electrocardiogram , as when calculated by cardiotocography . Since normalised spectral values show little changes , the influence of autonomic modulation seems minor Background —Direct recordings from peripheral sympathetic nerves have shown an increased sympathetic drive in pregnancy-induced hypertension ( PIH ) and preeclampsia ( PE ) . It is unknown whether sympathetic drive is altered in normal pregnancy , when arterial blood pressure can be normal or relatively low . The aim of this study was to measure and compare peripheral sympathetic discharge , its vasoconstrictor effect and its baroreceptor control , during pregnancy and postpartum in women with normal pregnancy ( NP ) and PIH and in normotensive nonpregnant ( NN ) women . Methods and Results —Twenty-one women with NP , 18 women with PIH , and 21 NN women had  muscle sympathetic nerve activity  assessed from multiunit discharges ( MSNA ) and from single units with defined vasoconstrictor properties ( s-MSNA ) . The s-MSNA in NP ( 38±6.6 impulses/100 beats ) was greater ( P < 0.05 ) than in NN women ( 19±1.8 impulses/100 beats ) despite similar age and body weight but less than in PIH women ( P < 0.001 ) ( 146±23.5 impulses/100 beats ) . MSNA followed a similar trend . Cardiac baroreceptor reflex sensitivity ( BRS ) was impaired in NP and PIH women relative to NN . After delivery , sympathetic activity decreased to values similar to those obtained in NN , and there was an increase in BRS . In women with NP , the decrease in sympathetic output occurred despite an insignificant change in blood pressure . Conclusions — Central sympathetic output was increased in women with normal pregnancy and was even greater in the hypertensive pregnant group . The findings suggest that the moderate sympathetic hyperactivity during the latter months of normal pregnancy may help to return the arterial pressure to nonpregnant levels , although when the increase in activity is excessive , hypertension may ensue Discrete hidden Markov models ( HMMs ) were applied to classify pregnancy disorders . The observation sequence was generated by transforming RR and systolic blood pressure time series using symbolic dynamics . Time series were recorded from 15 women with pregnancy-induced hypertension , 34 with preeclampsia and 41 controls beyond 30th gestational week . HMMs with five to ten hidden states were found to be sufficient to characterize different blood pressure variability , whereas significant classification in RR-based HMMs was found using fifteen hidden states . Pregnancy disorders preeclampsia and pregnancy induced hypertension revealed different patho-physiological autonomous regulation supposing different etiology of both disorders Abstract Aims . The aim of the present study was to evaluate the influence of gestational hypertension on hemodynamics and cardiovascular autonomic regulation at rest and their responses to head-up tilt ( HUT ) . We prospect ively studied 56 pregnant women ( 28 with gestational hypertension and 28 healthy pregnant women ) during the third trimester of pregnancy and 3 months after pregnancy . Major findings . In women with pregnancy-induced hypertension , compared with control women , there were significant differences in hemodynamics and in markers of cardiovascular regulation ( p < 0.05 to p < 0.001 ) . Postural change from the supine to the upright position was associated with significant changes in hemodynamic responses in both groups during pregnancy ( from p < 0.05 to p < 0.001 ) . Regulatory response to HUT in both groups was characterized with a decrease in HF power and increase in LF/HF ratio ( from p < 0.01 to p < 0.001 ) . Responses to HUT in total power and VLF power were attenuated in hypertensive pregnancies ( p < 0.001 to p < 0.01 , respectively , vs control group ) . Conclusions . Our results suggest that autonomic cardiovascular regulation may not play a major role in women with gestational hypertension . The lack of irreversible changes in autonomic nervous function in hypertensive women appeared to be a feature of gestational-induced hypertension Objectives Offspring of hypertensive pregnancies have increased cardiovascular risk factors during childhood . We hypothesised that offspring of hypertensive pregnancies would demonstrate increased clinical levels of hypertension by young adult life , which would be proportional to the severity of the pregnancy complication . Design Prospect i ve birth cohort study Setting Tertiary obstetric hospital . Participants 2868 young adult offspring of women enrolled during pregnancy into the Western Australia Pregnancy Cohort ( Raine ) Study . Main outcome measures Cardiovascular risk , including incidence of hypertension and metabolic disease , in those born to hypertensive compared to normotensive pregnancies . Results Young adult offspring of hypertensive pregnancies were 2.5 times ( 95 % CI 1.32 to 4.56 , p=0.004 ) more likely to have global lifetime risk ( QRISK ) scores above the 75th centile . Thirty per cent of 20 year olds with hypertensive blood pressures were born following a hypertensive pregnancy . Pre-eclampsia or hypertension result ing in preterm birth associated with a threefold ( 95 % CI 1.3 to 7.0 , p=0.01 ) greater risk of being hypertensive by age 20 years , with no differences in body mass index . Whereas pregnancy-induced hypertension associated with a smaller 3±1 mm Hg blood pressure rise ( p=0.001 ) and a twofold ( 95 % CI 1.5 to 2.8 , p=0.001 ) greater risk of being obese or overweight . Risk factor associations were consistent throughout early life and independent of other birth-factors . Conclusions Incidence of offspring hypertension was significantly increased in those whose mothers had a more complicated pregnancy history , including preterm birth and pre-eclampsia Hypertensive disorders of pregnancy are associated with vascular dysfunction in the pregnancy and an increased risk of long-term cardiovascular disease ( CVD ) in the mother . What remains to be understood is whether the length , severity of the disease , the treatment of hypertension in pregnancy , or the subtype of hypertensive disorders of pregnancy are significant predictors of future CVD . We undertook a retrospective cohort study to review all women who gave birth at a tertiary hospital in Sydney between the years 1980 and 1989 ( n=31 656 ) . A cohort of women was further defined by having hypertension during the antenatal , intrapartum , or postnatal periods ( n=4387 ) . R and omly selected records of women ( n=1158 ) with a hypertensive disorder of pregnancy were individually review ed to collect data on their pregnancy and pregnancy outcomes . The entire cohort then underwent linkage analysis to future CVDs . Women who presented with gestational hypertension were at greater risk of future hypertension and ischemic heart disease compared with the women who were diagnosed with preeclampsia . There was no significant difference between the women who were treated with antihypertensive medication and the women who did not receive antihypertensive medication or the duration of hypertensive disorders of pregnancy and future admission for CVD , although severity of hypertension tracked with increased risk of future hypertension in all groups . This study demonstrated that all women who present with any of the subtypes of hypertensive disorders in pregnancy are at significant risk of future CVD compared with women who remain normotensive during their pregnancy Objective : To evaluate whether sympathetic activity is increased in early-onset hypertensive pregnancy and whether this can be influenced by management with plasma volume expansion . Methods : The study group consisted of 74 subjects , of which 37 had early-onset hypertensive disorders of pregnancy ( preeclampsia or gestational hypertension with fetal growth restriction ) , who were included at 24 to 34 weeks in a r and omized controlled trial of management with  ( n = 18 ) or without ( n = 19 ) plasma volume expansion  . Heart rate and blood pressure variabilities , LF/HF ratio for heart rate , baroreflex sensitivity , and phase difference at low frequency ( LF≈0.1 Hz ) were calculated by spectral analysis from continuous heart rate and blood pressure recordings of the finger pulse wave ( Portapres ™ , TNO ) . Measurements were performed at inclusion , after 20 to 40 hours and after 65 to 100 hours . The control group consisted of 29 women with a normal pregnancy and 8 women who had late-onset preeclampsia after 34 weeks . Controls were measured at 32 weeks . All controls had a normal blood pressures at that time . Results : LF variability of heart rate and blood pressure were significantly higher and baroreflex sensitivity was significantly lower in early-onset patients compared with normal controls . A significant trend towards higher LF variability of blood pressure and lower baroreflex sensitivity was found from normal controls to late-onset controls to early-onset patients . Parameters of sympathetic activity were not influenced by plasma volume expansion . Conclusion : Sympathetic activity was increased in early-onset hypertensive pregnancy . However , this was not affected by management with plasma volume expansion , suggesting that hypovolaemia in preeclampsia is a secondary phenomenon Background Although the exact pathophysiology of preeclampsia is not well understood , autonomic nervous system imbalance is suggested as one of the main factors . Aims To investigate heart rate variability ( HRV ) and autonomic modulations in Sudanese pregnant women with preeclampsia . Subjects and Methods A case-control study ( 60 women in each arm ) was conducted at Omdurman Maternity Hospital — Sudan , during the period from June to August , 2014 . Cases were women presented with preeclampsia and healthy pregnant women were the controls . Studied groups were matched for important determinants of HRV . Natural logarithm ( Ln ) of total power ( TP ) , high frequency ( HF ) , low frequency ( LF ) and very low frequency ( VLF ) were used to determine HRV . Normalized low and high frequencies ( LF Norm and HF Norm ) were used to evaluate sympathetic and parasympathetic autonomic modulations respectively . Results Patients with preeclampsia achieved significantly higher LF Norm [ 49.80 ( 16.25 ) vs. 44.55 ( 19.15 
    Output:
    
A decrease in overall HRV was found in preeclampsia ( PE ) , compared to normotensive pregnant controls .
A trend is seen towards increased low frequency/high frequency-ratio in women with PE compared to normotensive pregnant controls .
Our systematic review supports the hypothesis a sympathetic overdrive is found in HPD which is associated with a parasympathetic withdrawal .