Maturational changes in heart rate and heart rate variability in low birth weight infants

Sahni, Rakesh; Schulze, Karl; Kashyap, Sudha; Ohira-Kist, Kiyoko; Fifer, William P.; Myers, Michael

doi:10.1002/1098-2302(200009)37:2<73::aid-dev2>3.0.co;2-c

Cited by 52 publications

(35 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…There were also fewer sustained accelerations or decelerations of heart rate in the prone position. In addition, the positional differences in heart rate increased in quiet sleep with increasing postnatal age and the differences in HRV increased in both sleep states (Sahni et al, 2000). Maternal smoking during pregnancy is associated with preterm birth and is also an independent risk factor for SIDS.…”

Section: Sids Risk Factors and Preterm Birthsupporting

confidence: 89%

Cardiovascular Consequences of Preterm Birth in the First Year of Life

Fyfe¹,

Yiallourou²,

Horne³

2012

Preterm Birth - Mother and Child

View full text Add to dashboard Cite

Section: Sids Risk Factors and Preterm Birthsupporting

confidence: 89%

Cardiovascular Consequences of Preterm Birth in the First Year of Life

Fyfe¹,

Yiallourou²,

Horne³

2012

Preterm Birth - Mother and Child

View full text Add to dashboard Cite

“…H eart rate (HR) and heart rate variability (HRV) are increasingly used to detect a variety of pathophysiologic alterations in the autonomic nervous system (ANS) regulation of cardiac control mechanisms (1). Infants who succumb to sudden infant death syndrome have higher HR and reduced HRV compared with other infants; one speculation is that autonomic disturbances may lead to cardiac instability or may indicate ANS alterations with the potential to affect other vital functions (2).…”

mentioning

confidence: 56%

Autonomic Alterations in Cocaine-Exposed Neonates Following Orthostatic Stress

et al. 2007

View full text Add to dashboard Cite

ABSTRACT:We investigated the effects of prenatal cocaine exposure (PCE) on heart rate (HR) and heart rate variability (HRV) in the presence of orthostatic stress among near-and full-term neonates. PCE infants (n ϭ 21) and controls (n ϭ 23) were enrolled within 120 h of birth. ECG was recorded for an hour during quiet sleep, 30 min in supine position and then 30 min in an inclined position. Linear mixed models were used to analyze HR and HRV in the time domain and wavelet and power spectrum analyses in the frequency domain. PCE infants had tachycardia both before (p ϭ 0.091) and after tilting (p ϭ 0.015), but with a clear interaction between PCE and orthostatic stress (p ϭ 0.049). Compared with controls, PCE infants had a delayed and prolonged reaction to orthostatic stress. There was also a pronounced interaction with regard to log-transformed SDDRR, a measure of HRV (p ϭ 0.049). Controls experienced an instantaneous increase in log (SDDRR) followed by a prompt return to normal levels, while PCE infants had a gradual increase that did not dissipate quickly. Frequency-domain analyses also distinguished between the cocaine-exposed infants and the controls. Results suggest that the effects of PCE on the development of sympathetic and parasympathetic systems could lead to altered cardiovascular function. H eart rate (HR) and heart rate variability (HRV) are increasingly used to detect a variety of pathophysiologic alterations in the autonomic nervous system (ANS) regulation of cardiac control mechanisms (1). Infants who succumb to sudden infant death syndrome have higher HR and reduced HRV compared with other infants; one speculation is that autonomic disturbances may lead to cardiac instability or may indicate ANS alterations with the potential to affect other vital functions (2). Moreover, the circadian range of HR and certain quantities related to blood pressure (BP) are predictors of neonatal cardiovascular events (3). Hence, power spectrum analysis (PSA) of HRV has been used to assess fetal viability and maturity of the ANS (4,5).Cocaine use by pregnant women has continued to be a prevalent public health problem. Prenatal cocaine exposure (PCE) may lead to abruptio placentae, premature delivery, intrauterine growth restriction, congenital malformations, and fetal death (6 -8). However, controversy exists regarding the influences of PCE on the ANS control mechanism and on neonatal cardiovascular function. Some studies (9 -11), have found elevated HR and reduced HRV in infants with PCE. On the other hand, Regalado et al. (12) found reduced HR and increased HRV following PCE, while another study focusing on the nonlinear dynamics of HRV (13) found no significant differences between PCE infants and controls in spectral power distribution, approximate entropy, correlation dimension, or nonlinear predictability. Spectral analyses in particular have not yielded a consensus about the nature of PCEinduced autonomic alterations. Higher HRV was attributed to increased spectral power across all frequency bands in quiet sl...

show abstract

“…The increases in SD and sample asymmetry are consistent with increasing postnatal responsiveness of autonomic control of heart rate (31,32). In particular, the increase in sample asymmetry reflects an increasing proportion of decelerations over accelerations, consistent with increasing vagal activity.…”

Section: Abnormal Hrc In Neonatal Sepsismentioning

confidence: 99%

Abnormal Heart Rate Characteristics Preceding Neonatal Sepsis and Sepsis-Like Illness

et al. 2003

View full text Add to dashboard Cite

Late-onset neonatal sepsis is a significant cause of morbidity and mortality, and early detection could prove beneficial. Previously, we found that abnormal heart rate characteristics (HRC) of reduced variability and transient decelerations occurred early in the course of neonatal sepsis and sepsis-like illness in infants in a single neonatal intensive care unit (NICU). We hypothesized that this finding can be generalized to other NICUs. We prospectively collected clinical data and continuously measured RR intervals in all infants in two NICUs who stayed for Ͼ7 d. We defined episodes of sepsis and sepsis-like illness as acute clinical deteriorations that prompted physicians to obtain blood cultures and start antibiotics. A predictive statistical model yielding an HRC index was developed on a derivation cohort of 316 neonates in the University of Virginia NICU and then applied to the validation cohort of 317 neonates in the Wake Forest University NICU. In the derivation cohort, there were 155 episodes of sepsis and sepsis-like illness in 101 infants, and in the validation cohort, there were 118 episodes in 93 infants. In the validation cohort, the HRC index 1) showed highly significant association with impending sepsis and sepsis-like illness (receiver operator characteristic area 0.75, p Ͻ 0.001) and 2) added significantly to the demographic information of birth weight, gestational age, and days of postnatal age in predicting sepsis and sepsis-like illness Abbreviations BW, birth weight GA, gestational age HRC, heart rate characteristics HRV, heart rate variability NICU, neonatal intensive care unit ROC, receiver operating characteristic SampEn, sample entropy UVA, University of Virginia WFU, Wake Forest University Late-onset nosocomial neonatal sepsis occurs after 3 days of life and is a major health problem in high-risk newborn infants in the neonatal intensive care unit (NICU). It occurs in 25% of very low birth weight (Ͻ1500 g) infants and leads to a more than doubling of mortality and a 50% increase in hospital stay (1). Early detection is very difficult using clinical signs and currently available laboratory tests (2, 3). Clinicians have found neither to be reliable (4, 5), and the diagnostic challenge is manifest in the Centers for Disease Control and Prevention's definition that allows diagnosis of neonatal "clinical sepsis" with either a negative blood culture or no blood culture at all (6). These high-stakes uncertainties lead to two shortcomings of the current practice. First, infants with sepsis are often detected only when seriously ill, increasing morbidity and mortality and lowering the chance for prompt, complete recovery with antibiotic therapy. Second, physicians have a very low threshold for suspecting sepsis, and as many as 10 -20 infants are treated unnecessarily for every infant who truly is septic (3-5). The National Institute of Child Health and Human 0031-3998/03/5306-0920 PEDIATRIC RESEARCH Vol. 53, No. 6, 2003 Copyright © 2003 Printed in U.S.A. ABSTRACT920

show abstract

Maturational changes in heart rate and heart rate variability in low birth weight infants

Cited by 52 publications

References 32 publications

Cardiovascular Consequences of Preterm Birth in the First Year of Life

Cardiovascular Consequences of Preterm Birth in the First Year of Life

Autonomic Alterations in Cocaine-Exposed Neonates Following Orthostatic Stress

Abnormal Heart Rate Characteristics Preceding Neonatal Sepsis and Sepsis-Like Illness

Contact Info

Product

Resources

About