Using heart rate variability to predict neurological outcomes in preterm infants: a scoping review

Area of Science:

• Neonatal neurology
• Autonomic nervous system function
• Developmental pediatrics

Background:

• Preterm infants face elevated risks of neurological complications like intraventricular hemorrhage and white matter injury.
• These complications can lead to adverse neurodevelopmental outcomes and lower educational attainment post-discharge.
• Early detection and prediction of neurodevelopmental impairment are crucial for timely intervention.

Purpose of the Study:

• To conduct a scoping review on the utility of heart rate variability (HRV) monitoring for predicting neurological outcomes in preterm infants.
• To examine the association between HRV, brain injury, and neurodevelopmental outcomes in the preterm population.
• To assess the predictive value of HRV for both short-term and long-term neurological sequelae.

Main Methods:

• Systematic literature search across major databases (Medline, Embase, Web of Science, Cochrane Library).
• Inclusion of 15 relevant studies investigating HRV in preterm infants.
• Analysis of studies examining the relationship between HRV and brain injury, and HRV and long-term neurodevelopmental outcomes.

Main Results:

• Nine studies found an association between HRV and brain injury in preterm infants, with most indicating a correlation.
• Eight studies reported a significant association between HRV and long-term neurodevelopmental outcomes.
• Decreased HRV in the neonatal period appears to be a predictor of adverse neurological outcomes.

Conclusions:

• Reduced heart rate variability in preterm neonates is associated with both short-term brain injuries and long-term neurodevelopmental impairments.
• HRV monitoring shows potential as a non-invasive tool for predicting neurological complications in preterm infants.
• Further standardization of HRV metrics is needed for consistent clinical application and research.