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medRxiv PreprintsInternational5 November 2026

First-trimester nocturnal cardiorespiratory coupling during home sleep testing and later pregnancy complications: a secondary analysis of the nuMoM2b cohort

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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 deviati
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