Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Jul;84(1):85-91.
doi: 10.1038/s41390-018-0021-0. Epub 2018 May 23.

Neonatal autonomic function after pregnancy complications and early cardiovascular development

Christina Y L Aye  1   2 , Adam James Lewandowski  1 , Julien Oster  3 , Ross Upton  1 , Esther Davis  1 , Yvonne Kenworthy  1 , Henry Boardman  1 , Grace Z Yu  1 , Timo Siepmann  1 , Satish Adwani  4 , Kenny McCormick  4 , Yrsa B Sverrisdottir  5 , Paul Leeson  6
Affiliations

Neonatal autonomic function after pregnancy complications and early cardiovascular development

Christina Y L Aye et al. Pediatr Res. 2018 Jul.

Abstract

Background: Heart rate variability (HRV) has emerged as a predictor of later cardiac risk. This study tested whether pregnancy complications that may have long-term offspring cardiac sequelae are associated with differences in HRV at birth, and whether these HRV differences identify abnormal cardiovascular development in the postnatal period.

Methods: Ninety-eight sleeping neonates had 5-min electrocardiogram recordings at birth. Standard time and frequency domain parameters were calculated and related to cardiovascular measures at birth and 3 months of age.

Results: Increasing prematurity, but not maternal hypertension or growth restriction, was associated with decreased HRV at birth, as demonstrated by a lower root mean square of the difference between adjacent NN intervals (rMSSD) and low (LF) and high-frequency power (HF), with decreasing gestational age (p < 0.001, p = 0.009 and p = 0.007, respectively). We also demonstrated a relative imbalance between sympathetic and parasympathetic tone, compared to the term infants. However, differences in autonomic function did not predict cardiovascular measures at either time point.

Conclusions: Altered cardiac autonomic function at birth relates to prematurity rather than other pregnancy complications and does not predict cardiovascular developmental patterns during the first 3 months post birth. Long-term studies will be needed to understand the relevance to cardiovascular risk.

PubMed Disclaimer

Conflict of interest statement

Disclosure Statement

The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Overview of study design investigating whether (1) pregnancy complications had an effect on heart rate variability at birth and (2) if heart rate variability at birth predicted cardiovascular development at birth or at 3 months of age as measured by macrovascular, microvascular and cardiac assessments in the offspring. HRV indicates heart rate variability; SDNN standard deviation of the NN intervals; rMSSD root mean square of the difference between adjacent NN intervals; HF high frequency; LF low frequency and LV left ventricular.
Figure 2
Figure 2
Boxplots demonstrating (A) a significantly decreased rMSSD and increased heart rate in offspring born preterm but no significant difference in those exposed to maternal hypertension (B), preeclampsia (C) or those born small for gestational age (D). rMSSD indicates root mean square of the difference between adjacent NN intervals; HTN hypertensive pregnancy; PET preeclamptic pregnancy; SGA small for gestational age and AGA appropriate for gestational age.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Lombardi F, Sandrone G, Pernpruner S, et al. Heart rate variability as an index of sympathovagal interaction after acute myocardial infarction. Am J Cardiol. 1987;60:1239–1245. - PubMed
    1. Casolo G, Balli E, Fazi A, Gori C, Freni A, Gensini G. Twenty-four-hour spectral analysis of heart rate variability in congestive heart failure secondary to coronary artery disease. Am J Cardiol. 1991;67:1154–1158. - PubMed
    1. Swansburg ML, Brown CA, Hains SM, Smith GN, Kisilevsky BS. Maternal cardiac autonomic function and fetal heart rate in preeclamptic compared to normotensive pregnancies. Can J Cardiovasc Nurs. 2005;15:42–52. - PubMed
    1. Patural H, Pichot V, Jaziri F, et al. Autonomic cardiac control of very preterm newborns: a prolonged dysfunction. Early Hum Dev. 2008;84:681–687. - PubMed
    1. Goldstein B, Fiser DH, Kelly MM, Mickelsen D, Ruttimann U, Pollack MM. Decomplexification in critical illness and injury: relationship between heart rate variability, severity of illness, and outcome. Crit Care Med. 1998;26:352–357. - PubMed