Eiselt M, Curzi-Dascalova L, Clairambault J, Kauffmann F, Médigue C, Peirano P
Institute of Pathological Physiology, Friedrich Schiller University, Jena, Germany.
Early Hum Dev. 1993 Mar;32(2-3):183-95. doi: 10.1016/0378-3782(93)90011-i.
To investigate the influence of prematurity and postnatal age on the maturation of the autonomic nervous system function, we analysed heart-rate and heart-rate variability in twelve prematurely born infants (< 37 weeks gestational age) reaching the conceptional age of 37-41 weeks. These neonates were compared with sixteen 37-41 week conceptional age newborns (< 10 days postnatal age). Heart-rate variability was analysed by spectral analysis of interbeat intervals using Short-Time Fourier Transform. We found that during both active and quiet sleep, the durations of RR-intervals were shorter and the amplitude of heart-rate variability in different frequency bands was lower in prematures reaching term than in newborns of the same conceptional age (P < 0.001). Between-state comparison showed differences in both groups. In both groups, low-frequency heart-rate variability was higher in active sleep than in quiet sleep. Between-state differences of RR-intervals and high-frequency heart-rate variability were present only in newborns (P < 0.01). Discrimination between newborns and prematures reaching term, based on RR-intervals and heart-rate variability, was correct in both sleep states with errors between 7 to 16%. However, in both newborns and prematures reaching term, between-state discrimination showed less reliable results, especially for quiet sleep discrimination with 24% (in PRT) and 20% (in NB) of errors. Our results, especially information given by factor analysis, suggest that the differences between newborns and prematures reaching term, concerning RR-interval and heart-rate variability, may be related to a changed balance between the sympathetic and parasympathetic nervous systems with a diminished parasympathetic component of heart rate control in prematures reaching term, as compared to newborns.
为了研究早产和出生后年龄对自主神经系统功能成熟的影响，我们分析了12名孕周小于37周的早产婴儿（出生时孕周小于37周）在达到37 - 41周孕龄时的心率和心率变异性。将这些新生儿与16名孕龄为37 - 41周（出生后年龄小于10天）的新生儿进行比较。使用短时傅里叶变换通过心跳间期的频谱分析来分析心率变异性。我们发现，在主动睡眠和安静睡眠期间，足月早产婴儿的RR间期持续时间较短，不同频带的心率变异性幅度低于相同孕龄的新生儿（P < 0.001）。状态间比较显示两组均存在差异。在两组中，主动睡眠时低频心率变异性高于安静睡眠时。RR间期和高频心率变异性的状态间差异仅在新生儿中存在（P < 0.01）。基于RR间期和心率变异性对新生儿和足月早产婴儿进行区分，在两种睡眠状态下都是正确的，错误率在7%至16%之间。然而，在新生儿和足月早产婴儿中，状态间区分的结果可靠性较低，尤其是安静睡眠区分时，错误率分别为24%（早产婴儿组）和20%（新生儿组）。我们的结果，特别是因子分析给出的信息表明，在RR间期和心率变异性方面，新生儿和足月早产婴儿之间的差异可能与交感神经系统和副交感神经系统之间平衡的改变有关，与新生儿相比，足月早产婴儿心率控制的副交感神经成分减少。
