Impact of Kangaroo mother care on autonomic cardiovascular control in foetal-growth-restricted preterm infants.

IF 3.1 3区医学 Q1 PEDIATRICS

Pediatric Research Pub Date : 2024-09-06 DOI:10.1038/s41390-024-03555-z

Yueyang Tian, Ishmael M Inocencio, Arvind Sehgal, Flora Y Wong

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Abstract

Background: Kangaroo mother care (KMC) is WHO-recommended for low-birth-weight infants, yet its impact on autonomic cardiovascular control in preterm foetal growth-restricted (FGR) infants remains unclear. We hypothesised that KMC would promote autonomic cardiovascular control, benefiting preterm FGR infants with reduced baseline autonomic function compared to appropriate for gestational age (AGA) infants.

Methods: Autonomic control was assessed via heart rate variability (HRV) in low frequency (LF) and high frequency (HF) bands using spectral analysis. Preterm FGR (n = 22) and AGA (n = 20) infants were assessed for 30-min before and 60-min during KMC. Comparisons were made between FGR and AGA infants; and between infants with baseline HRV below and above median.

Results: Overall, no significant HRV changes were observed during KMC for FGR or AGA infants compared to baselines. Infants with low baseline HRV LF showed increased HRV during KMC (p = 0.02 and 0.05 for the entire group and FGR group, respectively). This effect was absent in the AGA group regardless of baseline HRV. Infants with high baseline HRV had decreased HRV during KMC.

Conclusions: Infants with low baseline HRV, suggesting reduced autonomic control, are more likely to benefit from KMC with increased HRV. Further, this effect is stronger in FGR than AGA infants.

Impact: Kangaroo mother care (KMC) is WHO-recommended for low-birth-weight infants, yet its impact on autonomic cardiovascular control in preterm foetal growth-restricted (FGR) infants is unclear. Preterm infants with low baseline heart rate variability (HRV) are more likely to benefit from KMC and increase their HRV suggesting improved autonomic control. This effect is stronger in preterm FGR infants than those with appropriate growth for age.

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袋鼠妈妈护理对胎儿生长受限早产儿自律性心血管控制的影响。

背景：袋鼠妈妈护理（Kangaroo Mother Care，KMC）是世界卫生组织推荐用于低出生体重儿的护理方法，但其对早产胎儿生长受限（FGR）婴儿自律神经心血管控制的影响仍不清楚。我们假设 KMC 将促进自律神经对心血管的控制，从而使自律神经功能基线低于适宜胎龄（AGA）的早产 FGR 婴儿受益：采用频谱分析法，通过低频（LF）和高频（HF）波段的心率变异性（HRV）评估自律神经控制。早产 FGR 婴儿（22 人）和 AGA 婴儿（20 人）在 KMC 前 30 分钟和 KMC 期间 60 分钟接受了评估。对 FGR 和 AGA 婴儿进行了比较，并对基线心率变异低于中位数和高于中位数的婴儿进行了比较：总体而言，与基线相比，FGR 或 AGA 婴儿在 KMC 期间未观察到明显的心率变异。基线心率变异 LF 低的婴儿在 KMC 期间心率变异增加（全组和 FGR 组分别为 p = 0.02 和 0.05）。无论基线心率变异如何，AGA 组都没有这种效应。基线心率变异高的婴儿在 KMC 期间心率变异降低：结论：基线心率变异低的婴儿表明自律神经控制能力下降，更有可能从增加心率变异的 KMC 中获益。结论：基线心率变异较低的婴儿更容易从增加心率变异的 KMC 中获益，而且这种效应在 FGR 婴儿中比在 AGA 婴儿中更明显：袋鼠妈妈护理（Kangaroo Mother Care，KMC）是世界卫生组织推荐的低出生体重儿护理方法，但其对胎儿生长受限（FGR）早产儿自律性心血管控制的影响尚不清楚。基线心率变异性（HRV）较低的早产儿更有可能从 KMC 中获益并提高其 HRV，这表明自律神经控制得到了改善。这种效应在 FGR 早产儿中比那些生长发育符合年龄的早产儿更强。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Research 医学-小儿科

CiteScore

6.80

自引率

5.60%

发文量

473

审稿时长

3-8 weeks

期刊介绍： Pediatric Research publishes original papers, invited reviews, and commentaries on the etiologies of children''s diseases and disorders of development, extending from molecular biology to epidemiology. Use of model organisms and in vitro techniques relevant to developmental biology and medicine are acceptable, as are translational human studies