Impaired autonomic function in adolescents born preterm.

Kristin Haraldsdottir,Mari Palta,Laura H Tetri,Marlowe W Eldridge,Ryan M Centanni,Andrew M Watson,Kara N Goss,Arij G Beshish,Gregory P Barton,Melissa D Brix,David F Pegelow

doi:10.14814/phy2.13620

Kristin Haraldsdottir, Mari Palta + Show 9 more

Open Access

https://doi.org/10.14814/phy2.13620

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Journal: Physiological Reports	Publication Date: Mar 1, 2018
Citations: 42	License type: cc-by

Affiliation: University of Wisconsin–Madison

Abstract

Preterm birth temporarily disrupts autonomic nervous system (ANS) development, and the long‐term impacts of disrupted fetal development are unclear in children. Abnormal cardiac ANS function is associated with worse health outcomes, and has been identified as a risk factor for cardiovascular disease. We used heart rate variability (HRV) in the time domain (standard deviation of RR intervals, SDRR; and root means squared of successive differences, RMSSD) and frequency domain (high frequency, HF; and low frequency, LF) at rest, as well as heart rate recovery (HRR) following maximal exercise, to assess autonomic function in adolescent children born preterm. Adolescents born preterm (less than 36 weeks gestation at birth) in 2003 and 2004 and healthy age‐matched full‐term controls participated. Wilcoxon Rank Sum tests were used to compare variables between control and preterm groups. Twenty‐one adolescents born preterm and 20 term‐born controls enrolled in the study. Preterm‐born subjects had lower time‐domain HRV, including SDRR (69.1 ± 33.8 vs. 110.1 ± 33.0 msec, respectively, P = 0.008) and RMSSD (58.8 ± 38.2 vs. 101.5 ± 36.2 msec, respectively, P = 0.012), with higher LF variability in preterm subjects. HRR after maximal exercise was slower in preterm‐born subjects at 1 min (30 ± 12 vs. 39 ± 9 bpm, respectively, P = 0.013) and 2 min (52 ± 10 vs. 60 ± 10 bpm, respectively, P = 0.016). This study is the first report of autonomic dysfunction in adolescents born premature. Given prior association of impaired HRV with adult cardiovascular disease, additional investigations into the mechanisms of autonomic dysfunction in this population are warranted.

Highlights

With great advances in neonatal care over the past three decades, survival is improving for the lowest gestational age and birthweight infants (Ruegger et al 2012)
Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society
Adolescents born preterm were shorter in stature, but no statistically significant differences were identified with respect to BMI z score or percentile (Table 1)

Summary

Introduction

With great advances in neonatal care over the past three decades, survival is improving for the lowest gestational age and birthweight infants (Ruegger et al 2012). There has been increased interest in understanding the long-term effects of premature birth on multiple organ systems. The NIH recommends that premature birth be considered a long-term medical condition, though the long-term implications are only beginning to be understood. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society.

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