Abstract
BackgroundEarly postnatal period is characterized by dramatic adaptation changes of cardiovascular and respiratory systems in newborns. There is still insufficient data regarding maturation of autonomic regulatory mechanisms in neonates early after delivery. Aim of this study was to analyze cardiac autonomic regulation in newborns within the first few postnatal days in relation to different modes of delivery using time and spectral heart rate variability analysis.MethodsEutrophic healthy term newborns (n = 46) were divided into three groups according to the delivery mode: vaginal delivery (VD group; n = 16), vaginal delivery with epidural analgesia (EDA group; n = 16), and caesarean section under general anesthesia (CS group; n = 14). Heart rate variability (HRV), blood pressure (BP), and blood oxygen saturation (SpO2) were measured within the first two hours after birth and on the third to fourth postnatal day. HRV parameters were evaluated in the time domain (RR intervals, mean square of successive differences – MSSD) and frequency domain (total spectral power – TP, absolute and relative low and high frequency powers).ResultsThe HRV spectral analysis showed significantly higher relative power of the high-frequency band (HF%) in the VD group compared to the CS group early after delivery (p = 0.002). HRV parameters and BP significantly increased on the third to fourth postnatal day in all groups (p < 0.05). No significant differences in basic characteristics, BP and SpO2 were identified between groups during both measurements.ConclusionsHRV analysis revealed higher cardiovagal modulation in spontaneously born newborns without analgesia compared to neonates born by caesarean section. It could represent a potential pathomechanism that leads to discrete abnormal neurocardiac regulation associated with higher risk for worsened postnatal adaptation of cardiovascular system in surgically delivered neonates.
Highlights
Postnatal period is characterized by dramatic adaptation changes of cardiovascular and respiratory systems in newborns
This study investigated the potential effects of the delivery mode on cardiac autonomic regulation evaluated by the time and spectral Heart rate variability (HRV) analysis
These mechanisms are reduced in surgically delivered neonates, who have a higher risk for inadequate postnatal adaptation, that is associated with higher rates of respiratory morbidity [27], resulting in reduced HRV [28]
Summary
Postnatal period is characterized by dramatic adaptation changes of cardiovascular and respiratory systems in newborns. There is still insufficient data regarding maturation of autonomic regulatory mechanisms in neonates early after delivery. Heart rate variability (HRV) describes the oscillation in the interval between consecutive heartbeats as well as the oscillations between consecutive instantaneous heart rates [3] In this context, HRV could provide a unique noninvasive tool to obtain information about the early regulatory mechanisms of the cardiac dynamic sympathovagal balance. HRV could provide a unique noninvasive tool to obtain information about the early regulatory mechanisms of the cardiac dynamic sympathovagal balance This information could indicate physiological maturation and postnatal adaptation in newborns
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