Vagal Regulation of Heart Rate in the Prediction of Developmental Outcome for Very Low Birth Weight Preterm Infants

Abstract

To investigate heart rate and respiratory sinus arrhythmia (RSA) as markers of developmental outcome, infant ECG and 3 year outcome were assessed in 41 very low birth weight (< 1,500 g) infants. Measures of mean heart rate and RSA, and the maturational shifts in their values from 33 to 35 weeks gestational age, were recorded. RSA measures predicted 3 year outcome beyond the effects of birth weight, medical risk, and socioeconomic status. Higher RSA was associated with better social skills, whereas greater RSA maturation was associated with better mental processing and gross motor skills. Lower heart rate was associated with better behavior regulation and social skills, whereas greater maturational decreases were associated with better gross motor skills. Dividing the sample into groups of infants with birth weights less than 1,000 g and those with birth weights over 1,000 g, RSA maturation emerged a strong predictor of mental processing, knowledge base, and gross motor skills in the former. A measure of joint maturation of RSA and heart rate was associated with better behavior regulation at 3 years, as measured by Child Behavior Checklist and Parenting Stress Index scores, for this group. The findings directly respond to the need for physiological variables in the prediction of outcome in high-risk infants.

Prenatal cocaine and other substance exposure: Effects on infant autonomic regulation at 7 months of age

“…The failure to suppress RSA in response to environmental challenge is consistent with previous findings that infants with regulatory disorders did not regulate (decrease) RSA from baseline to a task (DeGangi et al, 1991). Since other studies have indicated that there is a positive association between vagal regulation and both concurrent and future behavioral regulation during frustration (Calkins, 1997) and social tasks (Doussard-Roosevelt, Porges, Scanlon, Alemi, & Scanlon, 1997;Stifter & Corey, 2001;Suess & Bornstein, 2000), the findings of the current study suggest that infants who were exposed to cocaine may be at risk for less adaptive behavioral regulation during environmental challenges.…”

Heart Rate Variability: Impact of Differences in Outlier Identification and Management Strategies on Common Measures in Three Clinical Populations

“…For example, the HRV parameters among our premature infants were all somewhat lower than those reported by those evaluating HRV in term infants (50,51), consistent with reports that HRV parameters are lower among infants of lower postconceptional age (21,22,25,36,50,(52)(53)(54). Likewise, our results for the values of HRV parameters in pediatric oncology patients are similar to those found in earlier studies (13); values for HRV parameters in oncology patients may be lower than healthy children of similar ages due to cardiac toxicity of anthracycline chemotherapy, pain or other symptoms (55).…”

Self-regulatory processes in early personality development: A multilevel approach to the study of childhood social withdrawal and aggression

“…The vagus is a cranial nerve that runs from the brain stem at the nucleus ambiguous to various body organs, which include the heart and digestive system, and promote dynamic feedback between the brain centers and the organs that regulate homeostasis. This coordinating role has led researchers to describe RSA not only as an index of neural control of the heart but also as an assessment of underlying regulatory abilities in mammals (Doussard-Roosevelt, Porges, Scanlon, Alemi, & Scanlon, 1997).…”