Dummy/pacifier use in preterm infants increases blood pressure and improves heart rate control.
BACKGROUND
Preterm infants are at increased risk of sudden infant death syndrome (SIDS). Use of a dummy/pacifier is thought to be protective against SIDS; accordingly, we assessed the effects of dummy/pacifier use on blood pressure, cerebral oxygenation, and heart rate control over the first 6 mo of life after term corrected age (CA) when SIDS risk is greatest.


METHODS
Thirty-five preterm infants were studied longitudinally at 2-4 wk, 2-3 mo, and 5-6 mo CA. Cardiac control was assessed from spectral indices of heart rate variability (HRV) in the low frequency (LF) and the high frequency (HF) range, and the ratio of HF/LF indicating sympathovagal balance was calculated.


RESULTS
Overall, at 2-3 mo, mean arterial pressure was significantly higher in the supine position in dummy/pacifier users in both quiet sleep (70 ± 2 vs. 60 ± 2 mm Hg; P < 0.05) and active sleep (74 ± 3 vs. 69 ± 2 mm Hg; P < 0.05). Dummy/pacifier users had higher LF HRV and LF/HF ratio and lower HF HRV.


CONCLUSIONS
Dummy/pacifier use increased blood pressure during sleep, at the age of greatest SIDS risk. Overall, LF HRV was elevated and HF HRV reduced in dummy/pacifier users, suggesting that dummy use alters cardiac control in preterm infants.
The Ritchie Centre, Hudson Institute of Medical Research, Monash University, Melbourne, Australia.|Department of Paediatrics, Monash University, Melbourne, Australia.
Rosemary S C
RS
Horne
The Ritchie Centre, Hudson Institute of Medical Research, Monash University, Melbourne, Australia.|Department of Paediatrics, Monash University, Melbourne, Australia.
Karinna L
KL
Fyfe
The Ritchie Centre, Hudson Institute of Medical Research, Monash University, Melbourne, Australia.
Alexsandria
A
Odoi
The Ritchie Centre, Hudson Institute of Medical Research, Monash University, Melbourne, Australia.
Anjalee
A
Athukoralage
The Ritchie Centre, Hudson Institute of Medical Research, Monash University, Melbourne, Australia.|Department of Paediatrics, Monash University, Melbourne, Australia.
Stephanie R
SR
Yiallourou
The Ritchie Centre, Hudson Institute of Medical Research, Monash University, Melbourne, Australia.|Department of Paediatrics, Monash University, Melbourne, Australia.|Monash Newborn, Monash Medical Centre, Melbourne, Australia.
Flora Y
FY
Wong
D000367:Age Factors; D062186:Arterial Pressure; D002560:Cerebrovascular Circulation; D005260:Female; D005865:Gestational Age; D006339:Heart Rate; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D008137:Longitudinal Studies; D008297:Male; D010100:Oxygen / Q000097:blood; D041361:Pacifiers; D016684:Prone Position; D065840:Protective Factors; D012307:Risk Factors; D012890:Sleep; D013398:Sudden Infant Death / Q000209:etiology / Q000517:prevention & control*; D016683:Supine Position; D013997:Time Factors
D010100:Oxygen