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Autonomic Functioning in Young Adults Born at Extremely Low Birth Weight
Karen J Mathewson1, Ryan J Van Lieshout1, Saroj Saigal1
1McMaster University, Hamilton, Ontario, Canada.
Insights
Adults born at extremely low birth weight (ELBW) show altered autonomic functioning, with lower heart rate variability (HF) and potentially uncoordinated blood pressure regulation compared to normal birth weight (NBW) peers.
Area of Science:
- Physiology
- Neonatology
- Cardiovascular Health
Background:
- Autonomic nervous system function is known to be affected in extremely low birth weight (ELBW) infants.
- Limited data exist on how these autonomic alterations persist into adulthood.
Purpose of the Study:
- To investigate the long-term effects of ELBW on adult autonomic functioning.
- To examine associations between birth weight and cardiovascular parameters in adulthood.
Main Methods:
- Compared 60 ELBW adults (ages 22-26) with 79 normal birth weight (NBW) controls.
- Assessed resting heart rate (R-R interval), high-frequency (HF) and low-frequency (LF) heart rate variability, and systolic (SBP) and diastolic (DBP) blood pressure.
Main Results:
- ELBW participants, particularly the smallest, exhibited significantly lower HF compared to NBW controls.
- Higher birth weight correlated positively with HF in both groups.
- In ELBW survivors, lower birth weight predicted faster heart rate and higher DBP, with poor coordination with baroreflex activity (LF).
Conclusions:
- Adult autonomic regulation may be significantly altered in individuals born extremely preterm.
- ELBW may have lasting impacts on cardiovascular control mechanisms into adulthood.
Abstract:
Autonomic functioning is altered in infants born at extremely low birth weight (ELBW; <1000 g), but we know little about how such alterations manifest in adulthood. We examined associations between birth weight and resting heart rate (R-R interval), high-frequency (HF) and low-frequency (LF) heart rate variability, and systolic (SBP) and diastolic (DBP) blood pressure, in 60 participants (ages 22-26) born at ELBW and free of major neurosensory impairment, and 79 controls born at normal birth weight (NBW; >2500 g). HF in the smallest-born ELBW participants was significantly lower than in NBW controls. In both groups, greater birth weight was associated with higher HF. Among ELBW survivors, lower birth weight predicted faster heart rate and higher DBP, but neither heart rate nor DBP appeared to be well-coordinated with baroreflex activity (LF), the principal mechanism for short-term blood pressure regulation. Adult autonomic regulation may be significantly altered in those born extremely preterm.
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