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Developmental patterns of heart rate and variability in prematurely-born infants with apnea of prematurity
J A Henslee1, V L Schechtman, M Y Lee
1Southwest SIDS Research Institute, Brazosport Memorial Hospital, Lake Jackson, TX 77566, USA.
Insights
Premature infants exhibit higher heart rates and lower heart rate variability compared to full-term neonates. These cardiovascular differences persist for at least six months, indicating long-lasting effects of preterm birth.
Area of Science:
- Cardiology
- Neonatology
- Developmental Pediatrics
Background:
- Premature infants often display altered cardiovascular regulation compared to full-term neonates.
- Preterm birth may have lasting impacts on the autonomic nervous system controlling heart activity.
Purpose of the Study:
- To investigate the developmental trajectory of heart rate and heart rate variability in symptomatic preterm infants up to six months of age.
- To compare cardiovascular autonomic control between preterm and full-term infants.
Main Methods:
- Acquired 50 long-term EKG and respiration recordings from preterm infants (24-35 weeks gestational age).
- Analyzed cardiac R-R intervals from one-minute epochs during regular respiration.
- Compared heart rate and variability metrics with 72 recordings from full-term infants at similar post-conceptional ages.
Main Results:
- At 40 weeks post-conception, preterm infants (especially those with apnea of prematurity) had higher heart rates and reduced heart rate variability than full-term infants.
- These cardiovascular differences persisted for six months in infants born before 30 weeks gestation.
- Infants born at 30-35 weeks with neonatal respiratory distress syndrome also showed persistent differences.
Conclusions:
- Preterm birth and associated complications significantly impact the development of cardiac autonomic control.
- Altered heart rate patterns and variability in preterm infants suggest long-term cardiovascular regulation challenges.
- Findings highlight the need for monitoring and potential interventions for cardiovascular health in preterm populations.
Abstract:
At equivalent post-conceptional ages, prematurely-born infants have higher heart rates and reduced heart rate variability, relative to full-term neonates. Premature birth might exert long-lasting effects on central and peripheral mechanisms that control cardiovascular activity. We assessed development of heart rate and heart rate variability in symptomatic preterm infants up to 6 months of age. Fifty 6.5-h evening recordings of EKG and breathing were obtained from prematurely-born infants (gestational ages: 24-35 weeks). Cardiac R-R intervals were captured with a resolution of +/- 0.5 msec. One-min epochs were selected from three periods of regular respiration in recordings from premature infants and 72 recordings of full-term infants at comparable post-conceptional ages. Mean heart rate and heart rate variability were determined for each recording. At 40 weeks post-conception, prematurely-born infants with apnea of prematurity showed higher heart rates and reduced heart rate variability than did full-term neonates. These differences between premature and full-term infants persisted throughout the next 6 months in those infants born prior to 30 weeks gestation, and in those infants born at 30-35 weeks who experienced respiratory distress syndrome (RDS) during the neonatal period. The findings suggest that premature delivery, or complications thereof, exerts long-lasting effects on cardiac control.