Evidence map›Paper›PMID 41038151›Full record

ArticleEarly human development2025

Heart rate variability is associated with self-regulation and stress neurobehavior in preterm infants.

E L Donnellan, R B Govindan, J Ngwa, N Andescavage, C Limperopoulos, A J du Plessis

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PubMed Full text at PMC Publisher
In one paragraph

Article in Early human development, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

E L DonnellanDeveloping Brain Institute, Children's National Hospital, Washington, DC, USA.
R B GovindanDeveloping Brain Institute, Children's National Hospital, Washington, DC, USA; Department of Pediatrics, The George Washington University School of Medicine, Washington, DC, USA; The Zickler Family Prenatal Pediatrics Institute, Children's National Hospital, Washington, DC, USA.
J NgwaDeveloping Brain Institute, Children's National Hospital, Washington, DC, USA; Department of Pediatrics, The George Washington University School of Medicine, Washington, DC, USA.
N AndescavageDepartment of Pediatrics, The George Washington University School of Medicine, Washington, DC, USA; Division of Neonatology, Children's National Hospital, Washington, DC, USA.
C LimperopoulosDeveloping Brain Institute, Children's National Hospital, Washington, DC, USA; Department of Pediatrics, The George Washington University School of Medicine, Washington, DC, USA; The Zickler Family Prenatal Pediatrics Institute, Children's National Hospital, Washington, DC, USA.
A J du PlessisDeveloping Brain Institute, Children's National Hospital, Washington, DC, USA; Department of Pediatrics, The George Washington University School of Medicine, Washington, DC, USA; The Zickler Family Prenatal Pediatrics Institute, Children's National Hospital, Washington, DC, USA; Department of Neurology School of Medicine and Health Sciences, The George Washington University, Washington, DC, USA. Electronic address: adupless@childrensnational.org.

Funding

Impaired Brain Development in a Premature Ex-utero EnvironmentR01HD099393 · NICHD · CHILDREN'S RESEARCH INSTITUTE · PI DU PLESSIS, ADRE JACQUES, LIMPEROPOULOS, CATHERINE · 2020 to 2024
$3.4M
Diversity Supplement: Clinical Pediatric Research Training for the Fetal-Neonatal BrainT32HD098066 · NICHD · CHILDREN'S RESEARCH INSTITUTE · PI DU PLESSIS, ADRE JACQUES, LIMPEROPOULOS, CATHERINE · 2020 to 2024
$1.7M
NICHD NIH HHS R01 HD099393NICHD NIH HHS T32 HD098066
6 · The paper itself

Abstract

backgroundThe NICU (neonatal intensive care unit) Network Neurobehavioral Scale (NNNS) quantitatively assesses several distinct neurobehavioral domains. Neurobehavioral states interface with the autonomic nervous system. We sought to determine if autonomic tone, measured by heart rate variability (HRV), is associated with performance on NNNS neurobehavioral subscales.

methodsUsing continuous electrocardiogram recordings, we derived the following HRV measures: short (α1), and long-term (α2) fractal scaling exponents and short (RMS1) and long-term (RMS2) root mean square fluctuations. The NNNS was completed around term equivalent age (TEA). Linear mixed effects models tested associations between six NNNS subscales and HRV metrics. Secondary analyses explored the role of postmenstrual age (PMA) on associations between NNNS and HRV. These associations were further tested in the earliest and latest postnatal NICU weeks for each infant.

resultsWe enrolled 39 premature infants (birth gestational age 23-36 weeks). Several HRV metrics were associated with Self-Regulation and Stress. After controlling for common NICU exposures (i.e. ventilation, steroids, caffeine and antibiotics), self-regulation was positively associated with alpha1 and RMS1 (standardized β = 0.262-0.284). Stress was associated negatively with alpha1 and RMS1 (standardized β = -0.283 to -0.286) and positively with alpha2 (standardized β = 0.245). Associations between Self-Regulation and Stress on RMS1 differed by PMA and NICU week, respectively. α1 and α2 at TEA predicted Stress (AUC = 0.730-0.775).

conclusionOf the six subscales examined, only Stress and Self-Regulation scores were associated with autonomic metrics in preterm infants. For short-term autonomic fluctuations, PMA and NICU week influenced this relationship. Furthermore, the fractal scaling exponents predict abnormal Stress scores.

Indexed as

Heart RateInfant BehaviorInfant, PrematureSelf-ControlStress, PsychologicalAutonomic Nervous SystemElectrocardiographyFemaleHumansInfant, NewbornIntensive Care Units, NeonatalMaleDetrended fluctuation analysisHeart rate variabilityNeonatal intensive care unitPretermSelf-regulationStress

Identifiers

PMID41038151
PMCPMC12658902

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.