University of Oulu

Noora Korkalainen, Timo Mäkikallio, Juha Räsänen, Heikki Huikuri & Kaarin Mäkikallio (2021) Antenatal hemodynamic findings and heart rate variability in early school-age children born with fetal growth restriction, The Journal of Maternal-Fetal & Neonatal Medicine, 34:14, 2267-2273, DOI: 10.1080/14767058.2019.1663816

Antenatal hemodynamic findings and heart rate variability in early school-age children born with fetal growth restriction

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Author: Korkalainen, Noora1,2; Mäkikallio, Timo3; Räsänen, Juha4;
Organizations: 1Department of Obstetrics and Gynecology, Oulu University Hospital and University of Oulu
2PEDEGO Research Group, University of Oulu, Finland
3Department of Cardiology, Oulu University Hospital, Oulu, Finland
4Department of Obstetrics and Gynecology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
5Department of Obstetrics and Gynecology, Turku University Hospital and University of Turku, Turku, Finland
Format: article
Version: accepted version
Access: open
Online Access: PDF Full Text (PDF, 0.2 MB)
Persistent link: http://urn.fi/urn:nbn:fi-fe202201209572
Language: English
Published: Informa, 2019
Publish Date: 2020-09-11
Description:

Abstract

Background: According to epidemiological studies, impaired intrauterine growth increases the risk for cardiovascular morbidity and mortality in adulthood. Heart rate variability (HRV), which reflects the autonomic nervous system function, has been used for risk assessment in adults while its dysfunction has been linked to poor cardiovascular outcome.

Objective: We hypothesized that children who were born with fetal growth restriction (FGR) and antenatal blood flow redistribution have decreased HRV at early school age compared to their gestational age matched peers with normal intrauterine growth.

Study design: A prospectively collected cohort of children born with FGR (birth weight <10th percentile and/or abnormal umbilical artery flow, n = 28) underwent a 24-hour Holter monitoring at the mean age of 9 years and gestational age matched children with birth weight appropriate for gestational age (AGA, n = 19) served as controls. Time- and frequency domain HRV indices were measured and their associations with antenatal hemodynamic changes were analyzed.

Results: Time- and frequency domain HRV parameters (standard deviation of R–R intervals, SDNN; low frequency, LF; high frequency, HF; LF/HF; very low frequency, VLF) did not differ significantly between FGR and AGA groups born between 24 and 40 weeks. Neither did they differ between children born with FGR and normal umbilical artery pulsatility or increased umbilical artery pulsatility. In total, 56% of the FGR children demonstrated blood flow redistribution (cerebroplacental ratio, CPR < −2 SD) during fetal life and their SDNN (p = .01), HF (p = .03) and VLF (p = .03) values were significantly lower than in FGR children with CPR ≥ −2SD.

Conclusions: Early school age children born with FGR and intrauterine blood flow redistribution demonstrated altered heart rate variability. These prenatal and postnatal findings may be helpful in targeting preventive cardiovascular measures in FGR.

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Series: Journal of maternal-fetal & neonatal medicine
ISSN: 1476-7058
ISSN-E: 1476-4954
ISSN-L: 1476-7058
Volume: 34
Issue: 14
Pages: 2267 - 2273
DOI: 10.1080/14767058.2019.1663816
OADOI: https://oadoi.org/10.1080/14767058.2019.1663816
Type of Publication: A1 Journal article – refereed
Field of Science: 3121 General medicine, internal medicine and other clinical medicine
Subjects:
Funding: This work was supported by the Alma och K.A. Snellman Foundation (NK), the Instrumentarium Foundation under [grant 180014 (NK)]; the Finnish Cultural Foundation under [grant 00180555] (NK) and Oulu University Health and Biosciences Doctoral Program (NK).
Copyright information: This is an Accepted Manuscript version of the following article, accepted for publication in The Journal of Maternal-Fetal & Neonatal Medicine. Noora Korkalainen, Timo Mäkikallio, Juha Räsänen, Heikki Huikuri & Kaarin Mäkikallio (2021) Antenatal hemodynamic findings and heart rate variability in early school-age children born with fetal growth restriction, The Journal of Maternal-Fetal & Neonatal Medicine, 34:14, 2267-2273, DOI: 10.1080/14767058.2019.1663816. It is deposited under the terms of the Creative Commons Attribution-NonCommercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
  https://creativecommons.org/licenses/by-nc/4.0/