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Baroreflex sensitivity in premature infants - relation to the parameters characterizing intrauterine and postnatal
K Haskova1, M Javorka, B Czippelova
1Clinic of Neonatology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava and University Hospital in Martin, Martin, Slovakia, Department of Physiology and Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovakia. Javorka@jfmed.uniba.sk.
Insights
Baroreflex sensitivity (BRS) in premature infants increases with gestational age, birth weight, and postconception age. Birth weight and postconception age are key predictors of BRS variability in these vulnerable newborns.
Area of Science:
- Neonatology
- Cardiovascular Physiology
- Developmental Pediatrics
Background:
- Baroreflex sensitivity (BRS) is crucial for cardiovascular regulation.
- Limited data exists on BRS and its determinants in premature newborns.
Purpose of the Study:
- To investigate the relationship between BRS and intrauterine (gestational age, birth weight) and postnatal (postconception age, actual weight) development in premature infants.
Main Methods:
- Studied 57 premature infants, grouped by developmental characteristics.
- Utilized continuous, noninvasive peripheral blood pressure monitoring (Portapres FMS).
Main Results:
- BRS, heart rate, and respiratory rate correlated significantly with gestational age, postconception age, birth weight, and actual weight.
- Increased age and weight correlated with higher BRS and diastolic arterial pressure, and lower heart/respiratory rates.
- Very premature infants had the lowest BRS (4.11 ms/mmHg) compared to light premature infants (8.12 ms/mmHg).
Conclusions:
- BRS progressively increases with postnatal and postconception age, as well as weight in premature infants.
- Birth weight and postconception age emerged as the strongest predictors of BRS, explaining 40% of interindividual variability.
Abstract:
At present, there are insufficient information about baroreflex sensitivity (BRS) and factors that determine BRS in premature newborns. The objective of this study was to determine the relationship between BRS and the characteristics that reflecting the intrauterine development (gestational age and birth weight), as well as postnatal development (postconception age and the actual weight of the child at the time of measurement). We examined 57 premature infants, who were divided into groups according to gestational age and postconception age as well as birth weight, and weight at the time of measurement. Continuous and noninvasive registration of peripheral blood pressure (BP) was performed in every child within 2-5 min under standard conditions using a Portapres (FMS) device. The results showed a close correlation of baroreflex sensitivity, heart rate and respiratory rate with gestational age, postconception age, birth weight and actual weight at the time of measurement premature newborns. An increase in the characteristics (ages and weights) resulted in increased BRS and diastolic arterial pressure (DAP), and in decreased heart and respiratory rates. Baroreflex sensitivity in the first week was in the group of very premature newborns the lowest (4.11 ms/mmHg) and in the light premature newborns was almost double (8.12 ms/mmHg). BRS increases gradually in relation to postnatal (chronological) and to postconception age as well as to birth and actual weight. The multifactor analysis of BRS identified birth weight and postconception age as the best BRS predictors. The two independent variables together explained 40 % of interindividual BRS variability.
