Key result
In utero cocaine exposure is linked to ~2-point lower heart rate variability in infants.
Why the study?
Studies using heart rate variability triangular index (HRVi) in infants with pathological conditions such as prenatal cocaine exposure are lacking.
Observational (n=310)
Single-blind
No
May signal autonomic effects in exposed newborns; extends HRVi utility to neonates but leaves open prognostic value.
BACKGROUND: In adults, heart rate variability triangular index (HRVi) is a highly reproducible measure of heart rate variability (HRV), which makes it more suitable for use in longitudinal studies. Although normative data have been published for newborns, studies in infants with pathological conditions are lacking. METHODS: From 1997 to 2000, within the first 4 days of life, we prospectively evaluated HRVi in cocaine-exposed asymptomatic newborns (N = 97) by Holter monitoring. Their data were compared with infants from two control groups (one with no in utero drug exposure, N = 102; the other with exposure to alcohol, nicotine, or marijuana but no cocaine, N = 111). RESULTS: In assessing concordance between and within operators for HRVi, the intraclass correlations were 0.983 (95% CI: 0.958, 0.994) and 0.997 (95% CI: 0.984, 0.999), respectively. Infants with in utero cocaine exposure had significantly (P < 0.0001) lower HRVi than those exposed to other drugs and to no drugs in utero. If abnormal HRVi is defined as < fifth percentile for the no drug exposed group (HRVi < 8), 10% of the cocaine-exposed newborns, in contrast to 2% in each of the control groups (P = 0.003) had abnormal values. CONCLUSION: HRVi is a reliable measure to study heart rate variability in newborns. Asymptomatic infants with in utero cocaine exposure have lower HRVi. Our study supports the clinical use of an abnormal HRVi as a value < 8 for newborn infants.
No takes yet. Share an insight, caveat, or question.
Mehta et al. (2002) conducted an observational in In utero cocaine exposure (n=310). In utero cocaine exposure vs. No in utero drug exposure (and exposure to alcohol, nicotine, or marijuana without cocaine) was evaluated on Heart rate variability triangular index (HRVi) (p=< 0.0001). Asymptomatic infants with in utero cocaine exposure had significantly lower heart rate variability triangular index compared to unexposed infants (mean 12.21 vs 14.12, P<0.0001).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: