Features of heart rate variability capture regulatory changes during kangaroo care in preterm infants

D.R. Kommers, R. Joshi, C. van Pul, N.L. Atallah, L.M.G. Feijs, S.G. Oei, S. Bambang Oetomo, P. Andriessen

Research output: Contribution to journalArticleAcademicpeer-review

33 Citations (Scopus)
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Objective: To determine whether heart rate variability (HRV) can serve as a surrogate measure to track regulatory changes during kangaroo care, a period of parental coregulation distinct from regulation within the incubator. Study design: Nurses annotated the starting and ending times of kangaroo care for 3 months. The pre-kangaroo care, during-kangaroo care, and post-kangaroo care data were retrieved in infants with at least 10 accurately annotated kangaroo care sessions. Eight HRV features (5 in the time domain and 3 in the frequency domain) were used to visually and statistically compare the pre-kangaroo care and during-kangaroo care periods. Two of these features, capturing the percentage of heart rate decelerations and the extent of heart rate decelerations, were newly developed for preterm infants. Results: A total of 191 kangaroo care sessions were investigated in 11 preterm infants. Despite clinically irrelevant changes in vital signs, 6 of the 8 HRV features (SD of normal-to-normal intervals, root mean square of the SD, percentage of consecutive normal-to-normal intervals that differ by >50 ms, SD of heart rate decelerations, high-frequency power, and low-frequency/high-frequency ratio) showed a visible and statistically significant difference (P

Original languageEnglish
Pages (from-to)92-98
JournalJournal of Pediatrics
Early online date15 Dec 2016
Publication statusPublished - 1 Mar 2017


  • Autonomic regulation
  • Heart rate variability
  • Kangaroo care
  • Preterm infants
  • Heart Rate/physiology
  • Humans
  • Kangaroo-Mother Care Method/methods
  • Female
  • Male
  • Infant, Premature/physiology
  • Infant, Newborn


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