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Background:The study aims to describe heart rate variability (HRV) in neonatal hypoxic ischemic encephalopathy (HIE) and correlate HRV with electroencephalographic (EEG) grade of HIE and neurodevelopmental outcome. Methods: Multichannel EEG and electrocardiography (ECG) were assessed at 12-48 h after birth in healthy and encephalopathic full-term neonates. EEGs were graded (normal, mild, moderate, and severe). Neurodevelopmental outcome was assessed at 2 y of age. Seven HRV features were calculated using normalized-RR (NN) interval. The correlation of these features with EEG grade and outcome were measured using Spearman's correlation coefficient. results: HRV was significantly associated with HIE severity (P < 0.05): standard deviation of NN interval (SDNN) (r = −0.62), triangular interpolation of NN interval histogram (TINN) (r = −0.65), mean NN interval (r = −0.48), and the very low frequency (VLF) (r = −0.60), low frequency (LF) (r = −0.67) and high frequency (HF) components of the NN interval (r = −0.60). SDNN at 24 and 48 h were significantly associated (P < 0.05) with neurodevelopmental outcome (r = −0.41 and −0.54, respectively). conclusion: HRV is associated with EEG grade of HIE and neurodevelopmental outcome. HRV has potential as a prognostic tool to complement EEG.

Antenatal diagnosis of HLHS was strongly associated with a superior pre-operative clinical status, but did not influence early survival after surgical palliation.

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The HF component of HRV is increased in infants with moderate HIE undergoing TH.