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Multi-parametric cardiorespiratory analysis in late-preterm, early-term, and full-term infants at birth

  • Maristella Lucchini
  • Nina Burtchen
  • William P. Fifer
  • Maria G. Signorini
Original Article
  • 68 Downloads

Abstract

Infants born at 35–37 weeks’ gestational age (GA) are at higher risk for a range of pathological conditions and poorer neurodevelopmental outcomes. However, mechanisms responsible are not fully understood. The purpose of this paper is to use traditional and novel techniques to assess newborn autonomic development as a function of GA at birth, focusing on cardiorespiratory regulation. ECG and respiration were acquired during sleep on 329 healthy newborns. Infants were divided into GA groups: 35–36 weeks (late preterm (LPT)), 37–38 weeks (early term (ET)), and 39–40 weeks (full term (FT)). Time domain, frequency domain, and non-linear measures were calculated. Increased heart rate short-term variability and complexity as a function of GA were observed in time domain and non-linear measures. Decreasing inter-breath interval variability was found as a function of GA, with increasing linear cardiorespiratory coupling. A complexity parameter (quadratic sample entropy) was less affected by arrhythmias and artifacts when compared to traditional measures. Results suggest lower maturation in LPT, with less developed cardiorespiratory regulation. This may confer risk for altered outcome, convergent with epidemiological findings. Reported examples show that a combination of methodological approaches can be beneficial to characterize autonomic maturation.

Graphical abstract

Keywords

Autonomic nervous system Prematurity Non-linear analysis Heart rate variability 

Notes

Funding information

The writing of this manuscript was supported by the Sackler Institute of Developmental Psychobiology at Columbia University and by National Institute of Health grants NIH Grants R37 HD32774 (WPF) and T32 MH018264 (NB) and by Rotary International Global Grant. This publication was also supported by the National Center for Advancing Translational Sciences and National Institutes of Health, through Grant Number UL1TR001873. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

Glossary of terms

ANS

Autonomic nervous system

ET

Early-term infants

FT

Full-term infants

GA

Gestational age

HF

High frequency

HoL

Hours of life

HR

Heart rate

HRV

Heart rate variability

IBI

Inter-breath interval

LPT

Late-preterm infants

MoD

Mode of delivery

NN

Normal to normal intervals, as the RR distances excluding anomalous beats

QSE

Quadratic sample entropy

RMSSD

Root mean of successive NN differences

RR

distance between consecutive QRS peaks

SDNN

Standard deviation of NN

SIDS

Sudden infant death syndrome

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Copyright information

© International Federation for Medical and Biological Engineering 2018

Authors and Affiliations

  1. 1.Department of PsychiatryColumbia University College of Physicians and SurgeonsNew YorkUSA
  2. 2.Dipartimento di Elettronica, Informazione e BioingegneriaPolitecnico di MilanoMilanoItaly
  3. 3.Department of Psychosomatic Medicine and PsychotherapyUniversity of FreiburgFreiburgGermany

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