Key result
Sample entropy of heart rate time series in preterm infants increased from 32 to 36 weeks of postmenstrual age (0.35 vs. 0.40; p < 0.01), reaching values of term infants at discharge.
Why the study?
It was unknown whether longitudinal sample entropy of heart rate time series reflects postnatal maturation in preterm infants or predicts discharge timing.
Does sample entropy of heart rate time series reflect postnatal maturation and predict discharge timing in preterm infants?
Cohort (n=263)
No
Does sample entropy of heart rate time series reflect postnatal maturation and predict discharge timing in preterm infants?
Absolute Event Rate: 0.4% vs 0.35%
p-value: p=< 0.01
Heart rate variability (sample entropy) increases with postnatal maturation in preterm infants but has limited prognostic value for predicting discharge timing.
SampEn tracks postnatal maturation in preterm infants but adds little to discharge prediction; leaves open its clinical utility beyond hypothesis-generating research.
Introduction: We assessed whether longitudinal measurements of sample entropy (SampEn) of heart rate time series reflect postnatal maturation in preterm infants and evaluated its predictive value at 32 weeks of postmenstrual age (PMA) for estimating discharge home. We further compared SampEn of preterm infants at discharge with that of term infants. METHODS: We conducted a prospective study at the University Children's Hospital Basel, Switzerland, from 2018 to 2022. We included preterm infants born before 32 weeks of gestation and a control group of term infants. Heart rate was recorded using the clinical monitoring system. We assessed preterm infants at 32 and 36 weeks of PMA, and at discharge, term infants were evaluated between 3 and 28 days of life. SampEn was calculated from 90-min recordings using custom analytical software. RESULTS: We obtained valid data from 183/183 preterm infants (mean [range] 28.4 [23.3-31.7] weeks of gestation) and from 80/104 (76%) term infants. In preterm infants, SampEn increased from 32 to 36 weeks of PMA (0.35 vs. 0.40; p < 0.01) without further increase to discharge. SampEn was positively associated with maturation and growth, and negatively with complications of prematurity, particularly with bronchopulmonary dysplasia. SampEn at 32 weeks of PMA did not improve clinical predictions of PMA at discharge. At discharge, SampEn did not differ significantly between preterm and term infants. CONCLUSION: SampEn of heart rate time series increased with postnatal maturation in preterm infants, reaching values of term infants at discharge. It was negatively associated with complications of prematurity but its prognostic value for discharge timing is limited. .
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Kaempfen et al. (2025) conducted a cohort in Preterm infants (n=263). Postnatal maturation (36 weeks PMA) vs. 32 weeks PMA was evaluated on Sample entropy (SampEn) of heart rate time series (p=< 0.01). Sample entropy of heart rate time series in preterm infants increased from 32 to 36 weeks of postmenstrual age (0.35 vs. 0.40; p < 0.01), reaching values of term infants at discharge.
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