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Neonatal heart rate variability and intraventricular hemorrhage: a case study
Charlene A Krueger1, Elizabeth A Gyland, Douglas W Theriaque
1University of Florida, Gainesville, FL, USA.
Insights
Heart rate variability (HRV) in preterm infants with intraventricular hemorrhage (IVH) showed altered spectral components compared to low-risk infants. This suggests HRV may help identify IVH in neonates.
Area of Science:
- Neonatal physiology
- Cardiovascular research
- Neurodevelopmental studies
Background:
- Preterm infants face risks, including intraventricular hemorrhage (IVH), impacting neurobehavioral organization.
- Heart rate variability (HRV) analysis offers insights into autonomic nervous system function in neonates.
Observation:
- This case study compared HRV spectral analysis in one preterm infant with Grade-III IVH to 38 low-risk preterm infants.
- Recordings were taken at 30 and 31 post-menstrual weeks during active sleep.
Findings:
- The infant with IVH exhibited elevated low-frequency HRV components at 30 weeks post-menstrual age.
- By 31 weeks, the IVH infant's low-frequency components decreased, while total and high-frequency components fell within the lower percentiles of controls.
Implications:
- Altered HRV patterns in preterm infants may indicate complications like IVH.
- HRV could serve as a non-invasive tool for identifying IVH and monitoring neurodevelopmental status in high-risk neonates.
Purpose:
The purpose of this study was to compare heart rate variability (HRV) in low-risk, pre-term infants to one infant diagnosed with intraventricular hemorrhage (IVH).
Method:
A case study design was used to compare HRV of one subject diagnosed with IVH to a convenience sample of 38 low-risk, pre-term infants at 30 and 31 post-menstrual weeks of age. Heart periods were recorded for 300-s with the infant in an active sleep state. Heart rate variability was quantified by spectral analysis. A confidence interval comparison of the total spectral components (0.02-2.0 Hz), high-frequency components (0.20-2.0 Hz), and the low-frequency components (0.02-0.20 Hz) was conducted.
Findings:
At 30 weeks' post-menstrual age, 10 days following diagnosis, with a grade-III IVH, the low frequency components were above the 90th percentile. One week later, at 31 weeks, the low frequency components had decreased to the 27th percentile range, and the total and high frequency components were at or below the 25th percentile range of the confidence intervals for the low-risk, pre-term infants.
Discussion:
The neurobehavioral organization of pre-term infants is limited due to prematurity and the cumulative effect of medical complications (such as IVH). This study has implications for the use of HRV in the identification of infants diagnosed with IVH.
