The Effect of Caffeine on Heart Rate Variability in Newborns: A Pilot Study

Area of Science:

• Neonatal medicine
• Cardiovascular physiology
• Autonomic nervous system function

Background:

• Neonatal apnoea is commonly treated with caffeine, a substance known to affect both the central nervous and cardiovascular systems.
• Heart rate variability (HRV) serves as a non-invasive indicator of autonomic nervous system (ANS) activity and maturation in neonates.

Purpose of the Study:

• To determine the impact of caffeine on HRV in newborns with apnoea.
• To explore the relationship between HRV and postmenstrual age (PMA) in this population.

Main Methods:

• Twenty-five stable newborns with apnoea receiving caffeine (2.5 mg/kg) were monitored for breathing frequency, oxygen saturation, body temperature, and heart rate during sleep.
• HRV was analyzed using spectral analysis with fast Fourier transformation before and 100 hours after caffeine withdrawal.

Main Results:

• Caffeine administration led to a significant increase in breathing frequency (p = 0.023) but did not significantly affect HRV or other assessed parameters.
• A significant positive correlation was observed between PMA and HRV (total power: p = 0.044; low-frequency band: p = 0.039) both during caffeine treatment and after its withdrawal.

Conclusions:

• The standard maintenance dose of caffeine appears insufficient to modulate heart rate or HRV in newborns.
• The observed positive correlation between PMA and HRV suggests that ANS maturation is a significant factor influencing HRV in neonates, independent of caffeine therapy.