Statistical modeling of heart rate variability to unravel the factors affecting autonomic regulation in preterm infants

Rohan Joshi, Deedee Kommers (Corresponding author), Chengcheng Guo, Jan-Willem Bikker, Loe Feijs, Carola van Pul, Peter Andriessen

Onderzoeksoutput: Bijdrage aan tijdschriftTijdschriftartikelAcademicpeer review

Uittreksel

Analyzing heart rate variability (HRV) in preterm infants can help track maturational changes and subclinical signatures of disease. We conducted an observational study to characterize the effect of demographic and cardiorespiratory factors on three features of HRV using a linear mixed-effects model. HRV-features were tailored to capture the unique physiology of preterm infants, including the contribution of transient pathophysiological heart rate (HR) decelerations. Infants were analyzed during stable periods in the incubator and subsequent sessions of Kangaroo care (KC) - an intervention that increases comfort. In total, 957 periods in the incubator and during KC were analyzed from 66 preterm infants. Our primary finding was that gestational age (GA) and postmenstrual age (PMA) have the largest influence on HRV while the HR and breathing rate have a considerably smaller effect. Birth weight and gender do not affect HRV. We identified that with increasing GA and PMA, overall HRV decreased and increased respectively. Potentially these differences can be attributed to distinct trajectories of intra- and extrauterine development. With increasing GA, the propensity towards severe HR decelerations decreases, thereby reducing overall variability, while with increasing PMA, the ratio of decelerations and accelerations approaches unity, increasing overall HRV.

TaalEngels
Artikelnummer7691
Aantal pagina's9
TijdschriftScientific Reports
Volume9
Nummer van het tijdschrift1
DOI's
StatusGepubliceerd - 22 mei 2019

Vingerafdruk

Premature Infants
Heart Rate
Deceleration
Gestational Age
Macropodidae
Incubators
Birth Weight
Observational Studies
Respiration
Demography

Citeer dit

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title = "Statistical modeling of heart rate variability to unravel the factors affecting autonomic regulation in preterm infants",
abstract = "Analyzing heart rate variability (HRV) in preterm infants can help track maturational changes and subclinical signatures of disease. We conducted an observational study to characterize the effect of demographic and cardiorespiratory factors on three features of HRV using a linear mixed-effects model. HRV-features were tailored to capture the unique physiology of preterm infants, including the contribution of transient pathophysiological heart rate (HR) decelerations. Infants were analyzed during stable periods in the incubator and subsequent sessions of Kangaroo care (KC) - an intervention that increases comfort. In total, 957 periods in the incubator and during KC were analyzed from 66 preterm infants. Our primary finding was that gestational age (GA) and postmenstrual age (PMA) have the largest influence on HRV while the HR and breathing rate have a considerably smaller effect. Birth weight and gender do not affect HRV. We identified that with increasing GA and PMA, overall HRV decreased and increased respectively. Potentially these differences can be attributed to distinct trajectories of intra- and extrauterine development. With increasing GA, the propensity towards severe HR decelerations decreases, thereby reducing overall variability, while with increasing PMA, the ratio of decelerations and accelerations approaches unity, increasing overall HRV.",
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Statistical modeling of heart rate variability to unravel the factors affecting autonomic regulation in preterm infants. / Joshi, Rohan; Kommers, Deedee (Corresponding author); Guo, Chengcheng; Bikker, Jan-Willem; Feijs, Loe; van Pul, Carola; Andriessen, Peter.

In: Scientific Reports, Vol. 9, Nr. 1, 7691, 22.05.2019.

Onderzoeksoutput: Bijdrage aan tijdschriftTijdschriftartikelAcademicpeer review

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