title: Fetal-growth-restricted preterm infants display compromised autonomic cardiovascular control on the first postnatal day but not during infancy.
abstract: BackgroundFetal growth restriction (FGR) is associated with increased perinatal mortality and long-term cardiovascular and neurodevelopmental sequelae. We hypothesized that FGR impacts on the development of autonomic heart rate and blood pressure control, contributing to unfavorable short- and long-term outcomes following FGR.MethodsWe studied 25 preterm FGR and 22 preterm and 19 term appropriate for gestational age (AGA) infants. Preterm neonates were studied on postnatal day 1, and all infants were studied at 1 and 6 months post-term age. To investigate autonomic cardiovascular control, we examined heart rate variability (HRV) and baroreflex sensitivity using spectral power and transfer-function analyses.ResultsPreterm FGR neonates exhibited higher heart rates and reduced HRV compared with preterm AGA controls on postnatal day 1. No significant differences were found between the three groups at 1 or 6 months post-term age.ConclusionPreterm FGR neonates display compromised HRV on postnatal day 1, which may suggest increased vulnerability to circulatory instability. This may predispose these neonates to systemic and cerebral hypoperfusion and increase the risk of long-term neurodevelopmental sequelae. Differences were no longer found at 1 and 6 months post-term age, suggesting that the maturation of autonomic cardiovascular control may be preserved following FGR.
authors.affiliation: The Ritchie Centre, Hudson Institute of Medical Research and Department of Paediatrics Monash University, Melbourne, Victoria, Australia.
authors.forename: Emily
authors.initials: E
authors.lastname: Cohen
authors.affiliation: The Ritchie Centre, Hudson Institute of Medical Research and Department of Paediatrics Monash University, Melbourne, Victoria, Australia.
authors.forename: Flora Y
authors.initials: FY
authors.lastname: Wong
authors.affiliation: The Ritchie Centre, Department of Obstetrics and Gynaecology, Monash University, Melbourne, Victoria, Australia.
authors.forename: Euan M
authors.initials: EM
authors.lastname: Wallace
authors.affiliation: Department of Obstetrics and Gynaecology, Monash University and Monash Women's, Monash Health, Melbourne, Victoria, Australia.
authors.forename: Joanne C
authors.initials: JC
authors.lastname: Mockler
authors.affiliation: The Ritchie Centre, Hudson Institute of Medical Research and Department of Paediatrics Monash University, Melbourne, Victoria, Australia.
authors.forename: Alexsandria
authors.initials: A
authors.lastname: Odoi
authors.affiliation: The Ritchie Centre, Hudson Institute of Medical Research and Department of Paediatrics Monash University, Melbourne, Victoria, Australia.
authors.forename: Samantha
authors.initials: S
authors.lastname: Hollis
authors.affiliation: The Ritchie Centre, Hudson Institute of Medical Research and Department of Paediatrics Monash University, Melbourne, Victoria, Australia.
authors.forename: Rosemary S C
authors.initials: RSC
authors.lastname: Horne
authors.affiliation: The Ritchie Centre, Hudson Institute of Medical Research and Department of Paediatrics Monash University, Melbourne, Victoria, Australia.
authors.forename: Stephanie R
authors.initials: SR
authors.lastname: Yiallourou
mesh_terms: D001341:Autonomic Nervous System / Q000503:physiopathology*; D001794:Blood Pressure; D002320:Cardiovascular Physiological Phenomena; D005317:Fetal Growth Retardation; D006339:Heart Rate; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature