Antenatal steroid exposure and heart rate variability in adolescents born with very low birth weight

Pediatr Res. 2017 Jan;81(1-1):57-62. doi: 10.1038/pr.2016.173. Epub 2016 Sep 15.

Abstract

Background: Reduced heart rate variability (HRV) suggests autonomic imbalance in the control of heart rate and is associated with unfavorable cardiometabolic outcomes. We examined whether antenatal corticosteroid (ANCS) exposure had long-term programming effects on HRV in adolescents born with very low birth weight (VLBW).

Methods: Follow-up study of a cohort of VLBW 14-y olds born between 1992 and 1996 with 50% exposed to ANCS. HRV in both the time and frequency domains using Nevrokard Software was determined from a 5-min electrocardiogram tracing.

Results: HRV data from 89 (35 male, 53 non-black) exposed (ANCS+) and 77 (28 male, 29 non-black) unexposed (ANCS-) adolescents were analyzed. HRV did not differ between ANCS+ and ANCS- black participants. However, in non-black participants, a significant interaction between ANCS and sex was observed, with ANCS- females having significantly greater HRV than ANCS+ females and males, and ANCS- males for both time and frequency domain variables.

Conclusion: Among non-black adolescents born with VLBW, ANCS exposure is associated with reduced HRV with apparent sex-specificity. Reduced HRV has been associated with development of adverse cardiometabolic outcomes, thus supporting the need to monitor these outcomes in VLBW adolescents as they mature.

MeSH terms

  • Adolescent
  • Adrenal Cortex Hormones / administration & dosage
  • Adrenal Cortex Hormones / adverse effects*
  • Analysis of Variance
  • Autonomic Nervous System / drug effects
  • Autonomic Nervous System / physiopathology
  • Black or African American
  • Cohort Studies
  • Female
  • Fetal Organ Maturity / drug effects
  • Follow-Up Studies
  • Heart Rate / drug effects*
  • Heart Rate / physiology
  • Humans
  • Infant, Newborn
  • Infant, Very Low Birth Weight
  • Male
  • North Carolina
  • Pregnancy
  • Prenatal Exposure Delayed Effects / physiopathology*
  • Sex Factors
  • White People

Substances

  • Adrenal Cortex Hormones