Key result
Preterm birth impairs the normal maturational increase in baroreflex sensitivity, resulting in a 29% lower BRS at 5 to 6 months corrected age during quiet sleep compared with term infants (P<.05).
Why the study?
Does preterm birth alter the maturation of baroreflex sensitivity in sleeping infants?
Cohort (n=56)
Does preterm birth alter the maturation of baroreflex sensitivity in sleeping infants?
p-value: p=<.05
Preterm birth impairs the normal maturational increase in baroreflex sensitivity, resulting in reduced BRS at 5 to 6 months during quiet sleep, which may increase the risk for cardiovascular instability and SIDS.
May increase cardiovascular instability and SIDS risk in preterm infants; hypothesis-generating for autonomic monitoring strategies.
OBJECTIVE: Impaired blood pressure (BP) control may underpin the increased incidence of the sudden infant death syndrome (SIDS) in preterm infants. This study aimed to examine the effects of preterm birth, postnatal age, and sleep state on BP control by measuring baroreflex sensitivity (BRS) across the first 6 months of term-corrected age (CA), when SIDS risk is greatest. METHODS: Preterm (n = 25) and term (n = 31) infants were studied longitudinally at 2 to 4 weeks, 2 to 3 months, and 5 to 6 months CA using daytime polysomnography. BP was recorded during quiet (QS) and active (AS) sleep using a photoplethysmographic cuff placed around the infant's wrist (Finometer [FMS, Finapres Medical Systems, Amsterdam, Netherlands]). BRS (milliseconds/mm Hg) was assessed in 1- to 2-minute epochs using cross-spectral analysis. RESULTS: In preterm infants, postnatal age had no significant effect on BRS within either QS or AS. This was in contrast to the maturational increase in QS observed in term infants. Compared with term infants, BRS of preterm infants was 38% higher at 2 to 4 weeks CA and 29% lower at 5 to 6 months CA during QS (P <.05). Comparing sleep states, BRS of preterm infants was 26% lower in QS compared with AS at 2 to 3 months CA (P <.05). CONCLUSIONS: Preterm birth impairs the normal maturational increase in BRS, resulting in a substantial reduction in BRS at 5 to 6 months CA during QS. Lower BRS during QS compared with AS at 2 to 3 months CA may place preterm infants at an increased risk for cardiovascular instability at this age of peak incidence of SIDS.
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Witcombe et al. (2011) conducted a cohort in Preterm birth (n=56). Preterm birth vs. Term birth was evaluated on Baroreflex sensitivity (BRS) during quiet and active sleep (p=<.05). Preterm birth impairs the normal maturational increase in baroreflex sensitivity, resulting in a 29% lower BRS at 5 to 6 months corrected age during quiet sleep compared with term infants (P<.05).
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