Autonomic development in preterm infants is associated with morbidity of prematurity

Authors

Sarah D. Schlatterer, Children's National Hospital, Prenatal Pediatrics Institute, Washington, DC, USA. sschlatt@childrensnational.org.
Rathinaswamy B. Govindan, Children's National Hospital, Prenatal Pediatrics Institute, Washington, DC, USA.
Scott D. Barnett, Children's National Hospital, Prenatal Pediatrics Institute, Washington, DC, USA.
Tareq Al-Shargabi, Children's National Hospital, Prenatal Pediatrics Institute, Washington, DC, USA.
Daniel A. Reich, Children's National Hospital, Prenatal Pediatrics Institute, Washington, DC, USA.
Sneha Iyer, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
Laura Hitchings, Children's National Hospital, Prenatal Pediatrics Institute, Washington, DC, USA.
G Larry Maxwell, Inova Women's and Children's Hospital, Fairfax, VA, USA.
Robin Baker, Inova Women's and Children's Hospital, Fairfax, VA, USA.
Adre J. du Plessis, Children's National Hospital, Prenatal Pediatrics Institute, Washington, DC, USA.
Sarah B. Mulkey, Children's National Hospital, Prenatal Pediatrics Institute, Washington, DC, USA.

Document Type

Journal Article

Publication Date

1-1-2022

Journal

Pediatric research

Volume

91

Issue

1

DOI

10.1038/s41390-021-01420-x

Abstract

BACKGROUND: Previous studies have described an association between preterm birth and maturation of the autonomic nervous system (ANS); however, this may be impacted by multiple factors, including prematurity-related complications. Our aim was to evaluate for the effect of prematurity-related morbidity on ANS development in preterm infants in the NICU. METHODS: We compared time and frequency domains of heart rate variability (HRV) as a measure of ANS tone in 56 preterm infants from 2 NICUs (28 from each). One cohort was from a high-morbidity regional referral NICU, the other from a community-based inborn NICU with low prematurity-related morbidity. Propensity score matching was used to balance the groups by a 1:1 nearest neighbor design. ANS tone was analyzed. RESULTS: The two cohorts showed parallel maturational trajectory of the alpha 1 time-domain metric, with the cohort from the high-morbidity NICU having lower autonomic tone. The maturational trajectories between the two cohorts differed in all other time-domain metrics (alpha 2, RMS1, RMS2). There was no difference between groups by frequency-domain metrics. CONCLUSIONS: Prematurity-associated morbidities correlate with autonomic development in premature infants and may have a greater impact on the extrauterine maturation of this system than birth gestational age. IMPACT: Autonomic nervous system development measured by time-domain metrics of heart rate variability correlate with morbidities associated with premature birth. This study builds upon our previously published work that showed that development of autonomic tone was not impacted by gestational age at birth. This study adds to our understanding of autonomic nervous system development in a preterm extrauterine environment. Our study suggests that gestational age at birth may have less impact on autonomic nervous system development than previously thought.

APA Citation

Schlatterer, Sarah D.; Govindan, Rathinaswamy B.; Barnett, Scott D.; Al-Shargabi, Tareq; Reich, Daniel A.; Iyer, Sneha; Hitchings, Laura; Larry Maxwell, G; Baker, Robin; du Plessis, Adre J.; and Mulkey, Sarah B., "Autonomic development in preterm infants is associated with morbidity of prematurity" (2022). GW Authored Works. Paper 485.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/485

Department

Pediatrics