Evaluation of autonomic nervous system function with heart rate variability analysis in preterm infants — a literature review
Abstract
Introduction. Preterm birth, despite the constant development of medicine and improved perinatal care, remains one of the greatest challenges in obstetrics. A prematurely born child presents a number of disorders, including abnormalities of the autonomic nervous system (ANS), which affect, among others, the functioning of the heart muscle. One method used to assess the influence of ANS activity on heart rate is the analysis of heart rate variability (HRV), which gives an indirect picture of its influence on the ability to adapt the systolic function of the ANS to external stimuli.
The aim of this study was to evaluate the activity of the autonomic nervous system on the basis of values of HRV parameters in children born prematurely on the basis of a literature review.
Material and methods. The literature review was carried out in accordance with PRISMA statement. Medical databases were reviewed including MEDLINE/PubMed, ProQest, PEDro, Cochrane, and Embase using the key phrases: ‘heart rate variability’ in combination with ‘preterm infants’.
Results. Between 1997 and 2018, 26 publications meeting the inclusion criteria were identified, of which 15 were selected for detailed analysis. Selected time and frequency domain HRV parameters were analysed in the review.
Conclusions. Preterm infants are susceptible to heart rhythm control disorders by the autonomic nervous system expressed by rapid and temporary changes in heart rate. They have higher heart rate and selected HRV parameters, suggesting a dominance of sympathetic activity in heart rate control. In addition, existing studies are not sufficiently systematic to be able to be compared to each other. Therefore, this subject requires further research.
Keywords: heart rate variabilityautonomic nervous systemprematurity
References
- Lawn JE, Davidge R, Paul VK, et al. Born too soon: care for the preterm baby. Reprod Health. 2013; 10(Suppl 1): S5.
- Bagnowska K. Factors affecting the efficacy of rehabilitation NDT-Bobath children born prematurely. Nowa Pediatr. 2014; 2: 63–71.
- Burchardt-Kroll E, Brązert K, Caputa J. In: Gadzinowski J, Szymankiewicz M, Gulczyńska E. ed. Podstawy neonatologii. Podręcznik dla studentów. Wydanie internetowe zmienione i rozszerzone . Oddział Wielkopolski Polskiego Towarzystwa Medycyny Perinatalnej, Poznań 2014: 18–20.
- Żytyńska-Daniluk J. Born prematurely. Triumph over nature technology. Probl Lek. 2011; 47(1): 64–68.
- Gwizdała A, Guzik P. Zmienność rytmu serca — podłoże fizjologiczne i zastosowanie kliniczne. Now Lek. 2001; 70(6): 601.
- Harrison MS, Eckert LO, Cutland C, et al. Brighton Collaboration Pathways to Preterm Birth Working Group. Electronic address: contact@brightoncollaboration.org. Pathways to preterm birth: case definition and guidelines for data collection, analysis, and presentation of immunization safety data. Vaccine. 2016; 34(49): 6093–6101.
- Heart rate variability: standards of measurement, physiological interpretation and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Circulation. 1996; 93(5): 1043–1065.
- Billman GE, Huikuri HV, Sacha J, et al. An introduction to heart rate variability: methodological considerations and clinical applications. Front Physiol. 2015; 6: 55.
- Longin E, Gerstner T, Schaible T, et al. Maturation of the autonomic nervous system: differences in heart rate variability in premature vs. term infants. J Perinat Med. 2006; 34(4): 303–308.
- Dimitrijević L, Bjelaković B, Čolović H, et al. Assessment of general movements and heart rate variability in prediction of neurodevelopmental outcome in preterm infants. Early Hum Dev. 2016; 99: 7–12.
- Moher D, Liberati A, Tetzlaff J, et al. PRISMA Group, PRISMA Group, PRISMA Group, PRISMA Group, PRISMA Group, PRISMA Group, PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement. Open Med. 2009; 3(3): e123–e130.
- Indic P, Salisbury Eb, Paydarfar D, et al. Interaction between heart rate variability and respiration in preterm infants. Comput Cardiol. 2008; 35: 57–60.
- Smith SL, Lux R, Haley S, et al. The effect of massage on heart rate variability in preterm infants. J Perinatol. 2013; 33(1): 59–64.
- Krueger C, van Oostrom JH, Shuster J. A longitudinal description of heart rate variability in 28–34-week-old preterm infants. Biol Res Nurs. 2010; 11(3): 261–268.
- Kommers DR, Joshi R, van Pul C, et al. Features of heart rate variability capture regulatory changes during kangaroo care in preterm infants. J Pediatr. 2017; 182: 92–98.e1.
- Silva MG, Gregório ML, de Godoy MF. Does heart rate variability improve prediction of failed extubation in preterm infants? J Perinat Med. 2019; 47(2): 252–257.
- Latremouille S, Al-Jabri A, Lamer P, et al. Heart rate variability in extremely preterm infants receiving nasal CPAP and non-synchronized noninvasive ventilation immediately after extubation. Respir Care. 2018; 63(1): 62–69.
- McCain GC, Knupp AM, Fontaine JL, et al. Heart rate variability responses to nipple feeding for preterm infants with bronchopulmonary dysplasia: three case studies. J Pediatr Nurs. 2010; 25(3): 215–220.
- Nakamura T, Horio H, Miyashita S, et al. Identification of development and autonomic nerve activity from heart rate variability in preterm infants. Biosystems. 2005; 79(1-3): 117–124.
- Selig FA, Tonolli ER, Silva EV, et al. Heart rate variability in preterm and term neonates. Arq Bras Cardiol. 2011; 96(6): 443–449.
- Mazursky JE, Birkett CL, Bedell KA, et al. Development of baroreflex influences on heart rate variability in preterm infants. Early Hum Dev. 1998; 53(1): 37–52.
- Lindh V, Wiklund U, Sandman PO, et al. Assessment of acute pain in preterm infants by evaluation of facial expression and frequency domain analysis of heart rate variability. Early Hum Dev. 1997; 48(1-2): 131–142.
- Thiriez G, Bouhaddi M, Mourot L, et al. Heart rate variability in preterm infants and maternal smoking during pregnancy. Clin Auton Res. 2009; 19(3): 149–156.
- Smith SL, Haley S, Slater H, et al. Heart rate variability during caregiving and sleep after massage therapy in preterm infants. Early Hum Dev. 2013; 89(8): 525–529.
- Jost K, Scherer S, De Angelis C, et al. Surface electromyography for analysis of heart rate variability in preterm infants. Physiol Meas. 2017; 39(1): 015004.
- Shaffer F, Ginsberg JP. An overview of heart rate variability metrics and norms. Front Public Health. 2017; 5: 258.
- Laborde S, Mosley E, Thayer JF. Heart rate variability and cardiac vagal tone in psychophysiological research — recommendations for experiment planning, data analysis, and data reporting. Front Psychol. 2017; 8: 213.
- Laborde S, Mosley E, Mertgen A. Vagal tank theory: the three Rs of cardiac vagal control functioning — resting, reactivity, and recovery. Front Neurosci. 2018; 12: 458.
- Żebrowski MR, Dębiec R, Trzos E, et al. Regulacja pracy serca i układu naczyniowego. Forum Kardiol. 2002; 7(3).
- Pawlak-Buś K, Kołodziejczyk-Feliksik M, Czerwiński-Mazur P, et al. Zmienność rytmu zatokowego - interpretacja patofizjologiczna i metodologia pomiarów. Folia Cardiol. 2003; 10(6): 719–726.
