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Updated: Mar 17, 2026
Measuring Cardiac Autonomic Nervous System ANS Activity in Children
Published on: April 29, 2013
Time domain parameters of heart rate variability in children born as small-for-gestational age
Agata Zamecznik1, Jerzy Stańczyk1, Agnieszka Wosiak2
11Department of Children's Cardiology and Rheumatology of the 2nd Chair of Pediatrics,Medical University of Lodz,Poland.
Insights
Children born small-for-gestational age show impaired autonomic nervous system function, indicated by lower heart rate variability. This may increase their risk for future cardiovascular diseases.
Area of Science:
- Pediatrics
- Cardiology
- Autonomic Neuroscience
Background:
- Metabolic programming theory links small-for-gestational age (SGA) birth to increased cardiovascular disease (CVD) risk.
- Autonomic nervous system (ANS) dysfunction is a potential mechanism contributing to this risk.
- Heart rate variability (HRV) is a key indicator of ANS function.
Purpose of the Study:
- To compare time-domain HRV parameters between SGA and appropriate-for-gestational age (AGA) children.
- To assess correlations between somatic parameters and HRV in SGA children.
- To investigate potential sex-based differences in HRV within the SGA group.
Main Methods:
- Holter monitoring was used to assess HRV in 68 SGA children (aged 5-10 years) and 30 matched AGA controls.
- Time-domain HRV parameters (SDNN, SDNNi, SDANNi, rMSSD, pNN50) were analyzed.
- Postnatal and current somatic parameters were correlated with HRV metrics.
Main Results:
- SGA children exhibited higher average heart rate compared to AGA children.
- All analyzed time-domain HRV parameters were significantly lower in the SGA group.
- Within the SGA group, girls showed lower heart rate and certain HRV parameters (SDNN, SDNNi, SDANNi) than boys.
- Autonomic balance in SGA children shifted towards sympathetic dominance, evidenced by elevated heart rate.
Conclusions:
- Children born SGA demonstrate impaired autonomic nervous system function.
- Reduced heart rate variability and a shift towards sympathetic activity in SGA children suggest an elevated risk for future cardiovascular diseases.
- These findings highlight the importance of monitoring cardiovascular health in individuals born SGA.
Abstract:
According to metabolic programming theory, small-for-gestational age patients are at high risk of cardiovascular diseases also because of the possible malfunction of the autonomic nervous system. Autonomic disorders can be assessed by heart rate variability. The aims of this study were to compare time domain parameters of heart rate variability in children born as small-for-gestational age and appropriate-for-gestational age and to assess the correlation of the postnatal and current somatic parameters with the time domain parameters. The small-for-gestational age group consisted of 68 children aged 5-10 years who were born with birth weight below the 10th percentile. The appropriate-for-gestational age group consisted of 30 healthy peers, matched in terms of gender and age. On the basis of Holter monitoring, slightly higher average heart rate was observed in the small-for-gestational age group than in the appropriate-for-gestational age group. It was found that all the time domain parameters (SDNN, SDNNi, SDANNi, rMSSD, pNN50) were lower in the small-for-gestational age group than in the appropriate-for-gestational age group. In the small-for-gestational age group, girls had lower heart rate and some of the heart rate variability parameters (SDNN, SDNNi, SDANNi) in comparison with boys. Children born as small-for-gestational age have impaired function of the autonomic nervous system. Moreover, in the small-for-gestational age group, autonomic balance moved towards the sympathetic component, which was evidenced by higher heart rate. Children with faster heart rate and lower heart rate variability parameters may be at risk of cardiovascular disease.
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