{
  "abstract": "We tested whether direction-specific nocturnal cardiorespiratory coupling (CRC) in the first trimester differed in pregnancies that later developed obstetric complications. The analysis included 2504 nulliparous women from the nuMoM2b cohort with valid level 3 home sleep recordings at 6-13 weeks' gestation. Bidirectional CRC between RR intervals and abdominal respiratory effort was quantified using bivariate phase-rectified signal averaging in consecutive 5-min segments. Coupling strength, local transition dynamics, and waveform irregularity were summarized by nightly mean and standard deviation. Associations with gestational diabetes mellitus (GDM; n = 111), preeclampsia (n = 149), preterm birth (n = 192), and fetal macrosomia (n = 186) were examined using proportional-odds models with CRC feature quintile as the ordered outcome. Models included all four complications simultaneously and adjusted for maternal age, pre-pregnancy body mass index, race and ethnicity, gestational age at recording, relevant medical and family history, medication use, and apnea-hypopnea index >5 events/h. Holm correction was applied across outcomes. GDM was associated with lower respiration-to-heart rate coupling strength (cumulative odds ratio, 0.45; 95% CI, 0.31-0.64; P < 0.001) and shallower slope at the anchor point (0.63; 0.45-0.89; P = 0.03). Fetal macrosomia was associated with lower within-night variability in heart rate-to-respiration waveform irregularity (0.59; 0.45-0.77; P < 0.001). No associations with preeclampsia or preterm birth remained significant after correction. Direction-specific differences in nocturnal CRC were detectable in the first trimester in pregnancies that later developed GDM or resulted in fetal macrosomia.",
  "abstract_shown": true,
  "affiliations": [
    "Eindhoven University of Technology"
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 11,
  "authors": [
    {
      "name": "Y. Wu"
    },
    {
      "name": "S. Asvadi"
    },
    {
      "name": "M. van der Ven"
    },
    {
      "name": "M. B. van der Hout-van der Jagt"
    },
    {
      "name": "E. Peri"
    },
    {
      "name": "R. Vullings"
    },
    {
      "name": "J. OEH van Laar"
    },
    {
      "name": "P. Fonseca"
    },
    {
      "name": "S. Overeem"
    },
    {
      "name": "M. Mischi"
    },
    {
      "affs": [
        0
      ],
      "name": "X. Long"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/3xt3dktekhwrp.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.11.02.26367117",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.11.02.26367117v1.full",
  "id": "3xt3dktekhwrp",
  "issns": [],
  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.11.02.26367117v1",
  "language": null,
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "health informatics"
    ]
  ],
  "openalex": null,
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.11.02.26367117v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-11-02",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/3xt3dktekhwrp.ris",
  "sources": [
    {
      "first_seen": "2026-11-05T12:20:16Z",
      "native_id": "10.64898/2026.11.02.26367117",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.11.02.26367117v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:health informatics",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "First-trimester nocturnal cardiorespiratory coupling during home sleep testing and later pregnancy complications: a secondary analysis of the nuMoM2b cohort",
  "title_text": "First-trimester nocturnal cardiorespiratory coupling during home sleep testing and later pregnancy complications: a secondary analysis of the nuMoM2b cohort",
  "type": "preprint",
  "updated_at": "2026-11-07T00:20:51Z",
  "url": "https://research.draconitic.com/paper/3xt3dktekhwrp",
  "venue": "medRxiv",
  "versions": []
}