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Published on: March 25, 2011
Cardiac Autonomic Function in Adults Born Preterm
Risto Karvonen1, Marika Sipola2, Antti Kiviniemi3
1Department of Chronic Disease Prevention, National Institute for Health and Welfare, Oulu and Helsinki, Finland; Research Unit for Pediatrics, Pediatric Neurology, Pediatric Surgery, Child Psychiatry, Dermatology, Clinical Genetics, Obstetrics and Gynecology, Otorhinolaryngology and Ophthalmology (PEDEGO), Medical Research Center Oulu, University of Oulu, Oulu, Finland.
Insights
Adults born preterm, even late preterm, show altered cardiac autonomic function. This may increase their risk for cardiovascular disease later in life.
Area of Science:
- Cardiology
- Autonomic Neuroscience
- Developmental Pediatrics
Background:
- Preterm birth is associated with long-term health consequences.
- Cardiac autonomic function plays a crucial role in cardiovascular regulation.
- Understanding the impact of prematurity on autonomic function is vital for predicting future health risks.
Purpose of the Study:
- To evaluate cardiac autonomic function in adults who were born preterm.
- To assess the association between the degree of prematurity and cardiac autonomic function.
- To investigate potential links between altered autonomic control and cardiovascular risk in preterm-born adults.
Main Methods:
- A cohort study involving 600 adults (mean age 23.3 years) born preterm (<37 weeks) or at term (≥37 weeks).
- Heart rate variability (HRV) measurements, including time and frequency domain analyses, were used to assess autonomic function.
- Linear regression models were employed to analyze the association between prematurity and HRV parameters, adjusting for relevant covariates.
Main Results:
- Adults born early preterm (<34 weeks) exhibited significantly reduced cardiac vagal activity (root mean square of successive differences) compared to controls (P=.04).
- The early preterm group also showed a trend towards reduced vagal activity and altered sympathetic-baroreflex effects (low frequency power) (P=.08).
- Late preterm infants (34-36 weeks) demonstrated significantly altered low frequency power, indicating potential autonomic dysregulation (P=.01).
Conclusions:
- Preterm birth, including late preterm birth, is associated with altered cardiac autonomic regulatory control in adulthood.
- These autonomic alterations may contribute to an increased risk of cardiovascular disease in individuals born preterm.
- Further research is warranted to explore interventions aimed at mitigating these long-term cardiovascular risks.
Objective:
To evaluate cardiac autonomic function in adults born preterm.
Study Design:
We studied the association between prematurity and cardiac autonomic function using heart rate variability measurements in 600 adults (mean age of 23.3 years) from a geographically based cohort in Northern Finland. There were 117 young adults born early preterm (<34 weeks), 207 born late preterm (34-36 weeks), and 276 born at term (≥37 weeks, controls). Autonomic function was analyzed by calculating time and frequency domain heart rate variability measurements using linear regression.
Results:
Compared with controls, the mean difference in root mean square of successive differences (indicating cardiac vagal activity) was -12.0% (95% CI -22.2%, -0.5%, adjusted for sex, age, source cohort, and season P = .04) for the early preterm group and -7.8% (-16.8%, 2.0%, P = .12) for the late preterm group. Mean differences with controls in low frequency power (indicating cardiac vagal activity, including some sympathetic- and baroreflex-mediated effects) were -13.6% (-26.7%, 1.8%, P = .08) for the early preterm group and -16.4% (-27.0%, -4.3%, P = .01) for the late preterm group. Mean differences in high frequency power (quantifying cardiac vagal modulation in respiratory frequency) were -19.2% (-36.6%, 2.9%, P = .09) for the early preterm group and -13.8% (-29.4%, 5.3%, P = .15) for the late preterm group. Differences were attenuated when controlled for body mass index and physical activity.
Conclusions:
Our results suggest altered autonomic regulatory control in adults born preterm, including those born late preterm. Altered autonomic regulatory control may contribute to increased cardiovascular risk in adults born preterm.
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