Assessing parasympathetic measures of heart rate variability shortly after birth to predict motor repertoire at four months in low risk preterm infants born between 28 and 32 weeks of gestation

Abstract

In low risk preterm infants, the risk for mild to moderate neuro-motor impairment is extremely high. Additionally, the autonomic nervous system (ANS) function was also found to be impaired. ANS activity may predict neuro-motor development at four months corrected age. This study examines the predictive value of the ANS function in detecting neuro-motor impairments during the first 4 months of life among low risk preterm infants born between 28 and 32 weeks of gestation. 46 infants were recruited. For each infant, heart rate variability (HRV) measures were obtained at week born, 32- and 35-weeks postmenstrual age (PMA). The General Movement Assessment (GMA) and the Motor Optimality Score for 3- to 5- Month- Old Infants (MOS) were performed at 35 weeks PMA and at 4 months corrected age respectively. A significant correlation was found between the parasympathetic nervous system (PSNS) components of HRV and the MOS evaluation. Preterm infants with suboptimal MOS scores showed significantly lower HRV values in the components of the PSNS (0.01 < p-value <0.04). A weak correlation was found between the HRV and the GMA. A Receiver Operating Characteristic was designed and revealed the predictive validity of the PSNS in preterm infants with a suboptimal MOS score. The current study shows that among very preterm infants with no additional risk factors, the PSNS component of HRV can predict neuro-motor outcome at 4 months corrected age and may be used as an early sign for mild neuro-motor impairments in order to initiate an early intervention program.