Preeclampsia exposed children's heart rate variability 8-12 years after index pregnancy (FINNCARE-study)

Background and Aim: Preeclampsia is related with elevated systolic blood pressure (SBP) in children. Our aim was to study if preeclampsia exposed (PE) children develop alterations in heart rate variability (HRV) and if this is reflected in their blood pressure (BP), as well as overall associations with body size and composition, gestational and perinatal factors. Methods: We examined 182 PE (46 early-onset PE) and 85 unexposed (non-PE) children 8-12 years after in-utero exposure to preeclampsia. HRV monitoring was performed 5 min in supine followed by 5 min in standing position and compared with office, 24-hour ambulatory and central BPs in relation to body anthropometrics and composition, gestational and perinatal data. Results: There were no major differences in HRV between PE and non-PE children. HRV in supine position was strongly associated with office and ambulatory heart rates (HRs), and HR was independently associated with office BPs. However, HRV was not related with office or 24-hour SBP and PP, nor with elevated SBP in PE children. Vagally mediated HF, rMSSD (inverse association) and LF/HF ratio (positive association), as a marker of sympathovagal balance, in supine position were independently associated with child adiposity. LF, HF and rMSSD displayed independent inverse associations with child age at follow-up. There were no significant associations between child HRV at follow-up and gestational and perinatal factors. Conclusion: HRV in PE children is like non-PE children during prepuberty, and elevated SBP following preeclampsia exposure is not related with HRV. Child adiposity could be related with decreased cardiac vagal tone.