University of Oulu

Karvonen, R., Sipola, M., Kiviniemi, A., Tikanmäki, M., Järvelin, M.-R., Eriksson, J. G., … Kajantie, E. (2019). Cardiac Autonomic Function in Adults Born Preterm. The Journal of Pediatrics, 208, 96–103.e4.

Cardiac autonomic function in adults born preterm

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Author: Karvonen, Risto1,2; Sipola, Marika1,2,3,4; Kiviniemi, Antti5;
Organizations: 1Department of Chronic Disease Prevention, National Institute for Health and Welfare, Oulu and Helsinki, Finland
2Research Unit for Pediatrics, Pediatric Neurology, Pediatric Surgery, Child Psychiatry, Dermatology, Clinical Genetics, Obstetrics and Gynecology, Otorhinolaryngology and Ophthalmology (PEDEGO), Medical Research Center Oulu, University of Oulu, Oulu, Finland
3Institute of Health Sciences, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
4Department of Pediatrics and Adolescence, Oulu University Hospital, Oulu, Finland
5Research Unit of Internal Medicine, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
6Department of Children and Families, Oulu and Helsinki, Finland
7Biocenter Oulu, Oulu, Finland
8Unit of Primary Care Unit, Oulu, Finland
9Department of Epidemiology and Biostatistics, Imperial College London, Medical Research Council Health Protection Agency Center for Environment and Health, School of Public Health, London, United Kingdom
10Department of General Practice and Primary Health Care, Helsinki, Finland
11Folkhälsan Research Center, Helsinki, Finland
12Hospital of Children and Adolescents, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
13Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
Format: article
Version: accepted version
Access: open
Online Access: PDF Full Text (PDF, 0.9 MB)
Persistent link:
Language: English
Published: Elsevier, 2019
Publish Date: 2020-02-04


Objective: To evaluate cardiac autonomic function in adults born preterm.

Study design: We studied the association between prematurity and cardiac autonomic function using heart rate variability measurements in 600 adults (mean age of 23.3 years) from a geographically based cohort in Northern Finland. There were 117 young adults born early preterm (<34 weeks), 207 born late preterm (34–36 weeks), and 276 born at term (≥37 weeks, controls). Autonomic function was analyzed by calculating time and frequency domain heart rate variability measurements using linear regression.

Results: Compared with controls, the mean difference in root mean square of successive differences (indicating cardiac vagal activity) was −12.0% (95% CI −22.2%, −0.5%, adjusted for sex, age, source cohort, and season P = .04) for the early preterm group and −7.8% (−16.8%, 2.0%, P = .12) for the late preterm group. Mean differences with controls in low frequency power (indicating cardiac vagal activity, including some sympathetic- and baroreflex-mediated effects) were −13.6% (−26.7%, 1.8%, P = .08) for the early preterm group and −16.4% (−27.0%, −4.3%, P = .01) for the late preterm group. Mean differences in high frequency power (quantifying cardiac vagal modulation in respiratory frequency) were −19.2% (−36.6%, 2.9%, P = .09) for the early preterm group and −13.8% (−29.4%, 5.3%, P = .15) for the late preterm group. Differences were attenuated when controlled for body mass index and physical activity.

Conclusions: Our results suggest altered autonomic regulatory control in adults born preterm, including those born late preterm. Altered autonomic regulatory control may contribute to increased cardiovascular risk in adults born preterm.

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Series: Journal of pediatrics
ISSN: 0022-3476
ISSN-E: 1097-6833
ISSN-L: 0022-3476
Volume: 208
Pages: 96 - 103.e4
DOI: 10.1016/j.jpeds.2018.12.061
Type of Publication: A1 Journal article – refereed
Field of Science: 3142 Public health care science, environmental and occupational health
Funding: The ESTER study was supported by grants from the Academy of Finland (SALVE program for 2009–2012 and grants 127437, 129306, 130326, 134791, and 263924 [to E.K.]); the Doctoral Program for Public Health, University of Tampere (to M.S.); the Emil Aaltonen Foundation (to E.K.); the Academy of Finland grant 267435 (to A.K.); the European Commission (Framework 5 award QLG1-CT-2000-001643 and Horizon2020 award 633595 DynaHealth [to M-R,J.]; Horizon2020 award 733280 RECAP Research on Children and Adults Born Preterm [to E.K.]); the Finnish Foundation for Pediatric Research (to E.K.); the Finnish Government Special Subsidiary for Health Sciences (evo) (to J.E.); Finska Läkaresällskapet (to J.E.); the Jalmari and Rauha Ahokas Foundation (to E.K.); the Juho Vainio Foundation (to E.K., M.T., and M.V.); the National Graduate School of Clinical Investigation (to M.T.); the Novo Nordisk Foundation (to E.K. and M.V.); the Signe and Ane Gyllenberg Foundation (to J.E. and E.K.); the Sigrid Jusélius Foundation (to E.K.); and the Yrjö Jahnsson Foundation (to E.K., M.S., and M.V.).
EU Grant Number: (633595) DYNAHEALTH - Understanding the dynamic determinants of glucose homeostasis and social capability to promote Healthy and active aging
Academy of Finland Grant Number: 267435
Detailed Information: 267435 (Academy of Finland Funding decision)
Copyright information: © 2019. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http:/