The status of autonomic nervous system and adaptation in infants with the different types of intrauterine growth restriction

Abstract

The article presents the characteristics of the status of autonomic nervous system and adaptation in babies with the different types of intrauterine growth restriction (IUGR). In infants the presence of symmetrical IUGR in comparison to asymmetrical IUGR is related to higher frequency of first- and second-degree cerebral ishaemia at birth and autonomic dysfunction starting from the second six months of life. Thus, babies with symmetrical IUGR display: lower sympathetic nervous system activity and depletion of adaptation reserves at the age of two-three days; higher sympathetic activity and strain on adaptation, high frequency of asympathicotonic responsiveness of the autonomic nervous system at the age of one month; higher sympathetic activity and higher frequency of adaptation strain with the prevalence of adaptation failure at the age of three months; lower sympathetic activity and higher frequency of asympathicotonic autonomic responsiveness at the age of six months; higher sympathetic activity and strain on compensatory reserves, higher frequency of asympathicotonic autonomic responsiveness and adaptation dysfunction with the prevalence of unsatisfactory adaptation at the age of 12 months. The proven facts should lead neonatologists and pediatricians to specifically monitor infants having had intrauterine growth restriction in their past medical history, especially those who have suffered from symmetrical intrauterine growth restriction, and to take preventive measures against autonomic dysfunction in the first six months of life of such infants and curative measures starting with non-pharmacologic ones or with a sparing use of drugs in the second six months of life. At the same time, infants having had asymmetrical intrauterine growth restriction demand special attention during the neonatal period and at the age of twelve months.