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Decreased heart rate variability in children born with low birth weight
Alexander Rakow1, Miriam Katz-Salamon, Mats Ericson
1Department of Woman and Child Health, Karolinska Institutet, Stockholm, Sweden. alexander.rakow@ki.se
Insights
Children born with low birth weight (LBW) exhibit altered autonomic nervous system (ANS) function, indicated by reduced heart rate variability. This suggests a potential early marker for future cardiovascular disease risk in LBW individuals.
Area of Science:
- Pediatrics
- Cardiology
- Autonomic Neuroscience
Background:
- Low birth weight (LBW) is linked to adult cardiovascular morbidity.
- Autonomic nervous system (ANS) dysfunction is a proposed mechanism for cardiovascular programming in LBW infants.
- This study investigates ANS function in children born with LBW.
Purpose of the Study:
- To determine if children born with LBW exhibit deviations in autonomic nervous system (ANS) function.
- To assess heart rate variability (HRV) as a marker of ANS function in LBW children.
Main Methods:
- Eighty-six children were studied: 31 preterm, 27 small for gestational age (SGA), and 28 controls.
- Twenty-four-hour Holter monitoring was conducted at approximately 9 years of age.
- Heart rate variability (HRV) was analyzed using time and frequency domain methods.
Main Results:
- Preterm and SGA children showed significantly lower frequency and time domain HRV parameters compared to controls.
- No significant difference in the low frequency/high frequency ratio was observed between LBW and control groups.
- Global ANS activity, estimated by total power, was reduced in LBW children.
Conclusions:
- Autonomic control is affected in children born with LBW, irrespective of gestational age.
- Reduced global ANS activity (total power) may serve as an early indicator of cardiovascular disease risk in LBW individuals.
- The balance between sympathetic and parasympathetic modulation may be less critical than global activity as an early marker.
Background:
Low birth weight (LBW) is associated with cardiovascular morbidity in adulthood. Imbalance in the autonomic nervous system (ANS) has been implicated as a mechanism behind the developmental programming of cardiovascular function. We hypothesized that deviations in the ANS function are seen in children born with LBW.
Methods:
Eighty-six children were included: 31 born preterm (<32 wk gestational age), 27 born at term but small for gestational age (SGA), and 28 born at term with normal birth weight (control). Twenty-four-hour Holter-electrocardiogram monitoring was performed at an average age of 9 y. Heart rate variability results were analyzed using frequency and time domain methods.
Results:
All frequency components and both time domain parameters tested were significantly lower in the preterm and SGA children compared with controls. The low frequency/high frequency ratio was not significantly different between children born with LBW and controls.
Conclusion:
The autonomic control appears to be affected in children born with LBW despite gestational age at birth. Decreased total power, as an estimation of the ANS's global activity, rather than the balance between parasympathetic and sympathetic modulation might be an early marker of cardiovascular disease later on in life for LBW born children.
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