a Department of Psychiatry and Behavioural Neurosciences , McMaster University , Hamilton , Canada.
b Department of Psychology, Neuroscience and Behaviour , McMaster University , Hamilton , Canada.
Int J Neurosci. 2019 Aug;129(8):776-783. doi: 10.1080/00207454.2019.1567511. Epub 2019 Feb 15.
Antenatal corticosteroid (ACS) therapy has dramatically increased survival rates among extremely low birth weight (ELBW) infants. However, the long-term effects of ACS on autonomic nervous system function have not been explored. Using the world's oldest longitudinally followed cohort of ELBW infants we compared respiratory sinus arrhythmia (RSA) among ELBW survivors whose mothers received ACS (ELBW-S), those who did not (ELBW-NS) and normal birth weight (NBW) controls in their 20 and 30 s. Resting electrocardiogram (ECG) was recorded from ELBW-S ( = 28), ELBW-NS ( = 36), and matched NBW controls ( = 79) at 22-26 and 29-36 years. Resting RSA was compared across groups analyses of covariance (ANCOVA), adjusting for sex, medication use, postnatal steroid exposure and the presence of chronic health conditions. RSA was also compared across assessments for each group. At 29-36 years, resting RSA in ELBW-S was significantly lower than in NBW controls. RSA in the ELBW-NS group was intermediate between ELBW-S and NBW groups. Although the ELBW-S group also showed nominally reduced RSA compared to NBW controls at the 22-26-year visit, this difference was not statistically significant. ELBW survivors exposed to ACS had lower RSA than NBW controls during their 30 s, suggestive of a decline in parasympathetic input to heart. ELBW survivors who received ACS may be particularly vulnerable to cardiovascular problems in later life.
产前皮质类固醇（ACS）治疗显著提高了极低出生体重（ELBW）婴儿的存活率。然而，ACS 对自主神经系统功能的长期影响尚未得到探索。我们使用世界上最古老的 ELBW 婴儿纵向队列，比较了接受 ACS 的 ELBW 幸存者（ELBW-S）、未接受 ACS 的 ELBW 幸存者（ELBW-NS）和正常出生体重（NBW）对照组在 20 多岁和 30 多岁时的呼吸窦性心律失常（RSA）。在 22-26 岁和 29-36 岁时，从 ELBW-S（n=28）、ELBW-NS（n=36）和匹配的 NBW 对照组（n=79）中记录休息时心电图（ECG）。使用协方差分析（ANCOVA）比较各组的休息 RSA，调整性别、药物使用、产后类固醇暴露和慢性健康状况的存在。还比较了每组的 RSA 评估。在 29-36 岁时，ELBW-S 的静息 RSA 明显低于 NBW 对照组。ELBW-NS 组的 RSA 介于 ELBW-S 和 NBW 组之间。尽管 ELBW-S 组在 22-26 岁时与 NBW 对照组相比，RSA 也有名义上的降低，但这一差异没有统计学意义。接受 ACS 治疗的 ELBW 幸存者在 30 多岁时的 RSA 低于 NBW 对照组，这表明心脏的副交感神经传入减少。接受 ACS 的 ELBW 幸存者在以后的生活中可能特别容易出现心血管问题。
