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Increased Heart Rate Variability Response Among Infants with Reported Rhinorrhea and Watery Eyes: A Pilot Study
Laura A Conrad1, Natalie Buchinsky2, Luis M Acosta2
1Division of Respiratory and Sleep Medicine, Albert Einstein College of Medicine, New York, NY, USA.
Insights
Infants with rhinorrhea and watery eyes without a cold (RWWC) showed greater heart-rate variability (HRV) decreases during stress. This suggests increased parasympathetic tone may link RWWC to later respiratory issues.
Area of Science:
- Pediatric Health
- Autonomic Nervous System Research
- Respiratory Medicine
Background:
- Infant rhinorrhea and watery eyes without a cold (RWWC) previously predicted school-age wheezing and respiratory events.
- These associations were independent of allergic sensitization.
- Increased parasympathetic tone was hypothesized as the underlying mechanism, supported by prior findings linking infant heart-rate variability (HRV) to wheeze.
Purpose of the Study:
- To test the hypothesis that infants with RWWC exhibit elevated HRV, indicating increased parasympathetic tone.
- To investigate the relationship between HRV and RWWC in early infancy.
Main Methods:
- Queried 3-month-old infants for RWWC symptoms since birth.
- Assessed HRV (root mean square of successive differences [RMSSD]) at 4 months using a standardized infant-mother still-face paradigm.
- The paradigm included play followed by a maternal still-face challenge.
Main Results:
- Among 38 participants, RWWC was more common in girls (32%) than boys (21%).
- Infants with the greatest decrease in RMSSD during the still-face challenge (lowest tertile) showed a higher prevalence of RWWC (50% vs. 16%, P=0.045).
- Logistic regression indicated that a greater decrease in HRV predicted higher odds of RWWC (OR=6.0, P=0.029), controlling for covariates.
Conclusions:
- This study suggests infants with RWWC experience greater decreases in HRV in response to a stressor.
- Findings indicate potentially increased parasympathetic tone or vagal reactivity in infants with RWWC.
- These results may offer insights into the early mechanisms linking infant symptoms to later respiratory conditions.
Introduction:
Previously, we found that reported infant rhinorrhea and watery eyes without a cold (RWWC) predicted school age exercise-induced wheeze, emergency department visits, and hospitalizations. These findings were independent of allergic sensitization, and we theorized that increased parasympathetic tone underlay the association. We also reported that increased heart-rate variability (HRV) in infants predicted wheeze in 2-3 year-olds. In a convenience sample of children participating in a birth cohort study, we tested the hypothesis that infants with RWWC would have elevated HRV, indicating increased parasympathetic tone.
Methods:
RWWC symptoms since birth were queried for 3-month-old children. At 4-months, HRV was assessed (root mean square of successive differences [RMSSD]) during a standardized infant-mother still-face paradigm, which included 2 minutes of mother/child play immediately followed by 2 minutes of the mother maintaining a still-face.
Results:
Among participants (n=38), RWWC was common for girls (32%) and boys (21%). The children with the greatest decrease in RMSSD between play and still-face challenge (lowest tertile) had a higher prevalence of RWWC as compared with children in the higher tertiles (50% vs 16%, P=0.045). In a logistic regression model controlling for sex, age and time between HRV and RWWC assessment, children with greater decrease in HRV between play and still-face (lowest tertile) had greater odds of having RWWC (odds ratio=6.0, P=0.029).
Conclusion:
In this relatively small study, we demonstrated greater decreases in HRV in response to a stressor among children with reported RWWC, suggesting that these children might have increased parasympathetic tone and/or overall greater vagal reactivity.
