Key result
Early measurements of heart rate variability and amplitude-integrated electroencephalogram parameters strongly correlated with time to an open-air cot (adjusted R2 = 0.72) and time to achieve full oral feeds (adjusted R2 = 0.53).
Why the study?
Among late preterm infants, there is significant variability in reaching milestones for safe discharge.
Do early measurements of heart rate variability and amplitude-integrated electroencephalography correlate with time to reach clinical milestones in late preterm infants?
Cohort (n=26)
Yes
Do early measurements of heart rate variability and amplitude-integrated electroencephalography correlate with time to reach clinical milestones in late preterm infants?
Effect estimate: Adjusted R2 = 0.72
p-value: p=<0.001
Early measurements of heart rate variability and amplitude-integrated electroencephalography correlate with the time to reach clinical milestones for safe discharge in late preterm infants.
Early HRV/aEEG measures may aid discharge timing predictions in late preterm infants; hypothesis-generating and requires larger prospective validation before practice change.
Background Among late preterm (LPT) infants, there is significant variability in reaching milestones for safe discharge. We examined the associations of early measures of heart rate variability (HRV) and amplitude-integrated electroencephalogram (aEEG) with time to wean to an open-air cot and to achieve full oral feeds. Methods This is a prospective, multicenter observational cohort study that enrolled infants between 340/7 and 346/7 weeks gestational age (GA). Infants with growth restriction and major congenital anomalies were excluded. Electrocardiogram (ECG) for 1 h and cross-cerebral aEEG for 6 h were recorded within 96 h after birth. Correlations of HRV and aEEG parameters with outcomes were evaluated using stepwise linear regression. Results Of the 26 infants from three centers, 23 were included for analysis for time to an open-air cot. The analysis for time to full oral feeds was limited to 19 infants from two centers with similar feeding policies. Including HRV parameters (time domain, median and standard deviation of R-wave to R-wave interval; frequency domain, ratio of the low frequency to high frequency power and their interaction) and aEEG parameters (total and immature cycles/hour) strengthened associations with time to open-air cot (adjusted R2 = 0.72) and time to full oral feeds (adjusted R2 = 0.53) compared with each parameter alone. Conclusions Early measurements of HRV and aEEG parameters correlate with time to an open-air cot and to achieve full oral feeds in LPT infants born between 340/7 and 346/7 weeks GA.
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Shah et al. (2025) conducted a cohort in Late preterm infants (n=26). Early measures of heart rate variability (HRV) and amplitude-integrated electroencephalogram (aEEG) was evaluated on Time to wean to an open-air cot (Adjusted R2 = 0.72, p=<0.001). Early measurements of heart rate variability and amplitude-integrated electroencephalogram parameters strongly correlated with time to an open-air cot (adjusted R2 = 0.72) and time to achieve full oral feeds (adjusted R2 = 0.53).
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