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Neonatal cardiovascular dynamics in relation to matroclinous and patroclinous history of high blood pressure
R C Hermida1, J R Fernández, D E Ayala
1Bioengineering Laboratory, ETSI Telecommunicación, University of Vigo, Spain.
Insights
Researchers developed a neonatal cardiovascular risk index using blood pressure and heart rate variability in newborns. This index helps evaluate prenatal interventions aimed at preventing future high blood pressure in children.
Area of Science:
- Neonatal physiology
- Cardiovascular health
- Genetics and disease predisposition
Background:
- Genetic factors significantly influence a newborn's predisposition to developing elevated blood pressure later in life.
- An accurate index is crucial for assessing the efficacy of prenatal interventions targeting maternal health to mitigate neonatal cardiovascular risk.
- Neonatal blood pressure and heart rate variability offer potential markers for early cardiovascular risk assessment.
Purpose of the Study:
- To develop and validate a neonatal index for cardiovascular risk assessment.
- To evaluate the effectiveness of this index in predicting future cardiovascular issues based on genetic and familial history.
- To determine the utility of this index for assessing the impact of maternal interventions during pregnancy.
Main Methods:
- Automated monitoring of systolic/diastolic blood pressure and heart rate in 127 neonates for 48 hours post-birth.
- Analysis of circadian parameters (amplitudes, ranges) and descriptive statistics using multiple regression.
- Calculation of a cardiovascular risk score based on familial history (parents, grandparents) of cardiovascular disease, hypertension, or obesity.
Main Results:
- The optimal predictive model incorporated circadian amplitudes of systolic and diastolic blood pressure, and circadian ranges of systolic blood pressure and heart rate.
- Both paternal and maternal family history contributed similarly to the predictive models for cardiovascular risk score.
- The developed index demonstrated a consistent predictive capability regardless of the maternal or paternal lineage.
Conclusions:
- A reliable neonatal index for cardiovascular risk has been established using early postnatal circulatory measurements.
- This index provides a valuable tool for evaluating the long-term effects of interventions implemented during pregnancy on the newborn's cardiovascular health.
- The findings support the use of neonatal physiological data and familial history for early identification of at-risk infants.
Abstract:
Genetic risk is a primary contributing factor to the predisposition of a newborn child to elevated blood pressure later in life. An index of this factor is needed to assess in the neonate the success or failure of preventive interventions instituted for the pregnant women. This index could be based on characteristics of blood pressure and heart rate variability measured during the first 2 days after birth. In the search for such an index, the systolic and diastolic blood pressures and heart rates of 127 newborn babies were automatically monitored at about 30-min intervals for 48 h with a Nippon Colin device, starting early after birth. Circadian parameters (obtained by the linear least-squares fit of a 24-h cosine curve to each individual series) and descriptive statistics for the three circulatory variables were used in a multiple regression analysis to compute a linear prediction function for the cardiovascular risk score. This score was obtained for each neonate on the basis of the presence or absence of overt cardiovascular disease, elevated blood pressure, or obesity across two generations, those of the newborn's parents and grandparents. Results from regression indicate that the best model includes the circadian amplitudes of systolic and diastolic blood pressure and the circadian ranges of systolic blood pressure and heart rate. The contributions from patroclinous versus matroclinous family history were then compared. Results show that linear prediction models include the same variables for both paternal and maternal cardiovascular risk score. These results provide a neonatal index of cardiovascular risk, to be used later for the evaluation of the effects on the newborn of intervention for the pregnant women.