Birth Weight and Its Relationship with the Cardiac Autonomic Balance in Healthy Children

Livia Victorino Souza, Vanessa Oliveira, Franciele De Meneck, Ana Paula Grotti Clemente, Maria Wany Louzada Strufaldi, Maria do Carmo Franco, Livia Victorino Souza, Vanessa Oliveira, Franciele De Meneck, Ana Paula Grotti Clemente, Maria Wany Louzada Strufaldi, Maria do Carmo Franco

Abstract

Several studies indicate that the fetal environment plays a significant role in the development of cardiometabolic disease later in life. However, a few studies present conflicting data about the correlation between birth weight and the impairment of cardiac autonomic modulation. The purpose of the present study was to provide further knowledge to elucidate this contradictory relationship. One hundred children aged 5 and 14 years had anthropometric parameters, body composition and blood pressure levels determined. Heart rate variability (HRV) was evaluated by heart rate monitoring, including measurements of both the time and frequency domains. The results showed inverse correlation between the HRV parameters with BMI (RMSSD: P = 0.047; PNN50: P = 0.021; HF: P = 0.041), systolic (RMSSD: P = 0.023; PNN50: P = 0.032) and diastolic (PNN50: P = 0.030) blood pressure levels. On the other hand, there were consistent positive correlations between the HRV parameters and birth weight (RMSSD: P = 0.001; PNN50: P = 0.001; HF: P = 0.002). To determine the effect of birth weight on HRV parameters, we perform multivariate linear regression analysis adjusted for potentially confounding factors (prematurity, gender, age, BMI, physical activity index and SBP levels). These findings were preserved even after adjusting for these confounders. Our results suggested that impaired cardiac autonomic modulation characterized by a reduction in the parasympathetic activity occurs in children with low birth weight. One possible interpretation for these data is that a vagal withdrawal, rather than a sympathetic overactivity, could precede the development of hypertension and other cardiometabolic diseases in children with low birth weight. However, long-term studies should be performed to investigate this possibility.

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1. Scatter plots showing the correlation…
Fig 1. Scatter plots showing the correlation between birth weight with systolic (A) and diastolic (B) blood pressure levels.
The lines represent the weighted regression with its 95% confidence interval.
Fig 2. Scatter plots showing the correlation…
Fig 2. Scatter plots showing the correlation between birth weight with parameters of the time domain: (A) RMSSD and (B) PNN50.
The lines represent the weighted regression with its 95% confidence interval.
Fig 3. Scatter plots showing the correlation…
Fig 3. Scatter plots showing the correlation between birth weight with HF, parameter of the frequency domain.
The lines represent the weighted regression with its 95% confidence interval.

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