Longitudinal Trajectories of Autonomic Maturation in Preterm Infants Using Serial 24-Hour Heart Rate Variability Monitoring.
4 affiliations
- 1Department of Neonatology, National Hospital Organization Shikoku Medical Center for Children and Adults, Zentsuji 765-8507, Japan.
- 2Department of Pediatrics, Faculty of Medicine, Kagawa University, Takamatsu 760-0016, Japan.
- 3Division of Neonatology, Perinatal Medical Center, Jichi Medical University, Shimotsuke 329-0498, Japan.
- 4Department of Pediatrics, Juntendo University Urayasu Hospital, Chiba 279-0021, Japan.
Abstract
Heart rate variability (HRV) is a non-invasive measure reflecting cardiac autonomic regulation and has been used to investigate developmental changes in preterm infants. Short-term HRV recordings have demonstrated developmental changes with advancing postmenstrual age (PMA), but are highly susceptible to transient physiological conditions, limiting reproducibility. We prospectively performed serial 24 h electrocardiographic recordings in 50 preterm infants born at 24-35 weeks' gestation from postnatal life until before 37 weeks' PMA to characterize longitudinal HRV trajectories. A total of 879 recordings were analyzed using a 24 h single-window approach, and developmental trajectories were evaluated using linear mixed-effects models. All HRV indices increased progressively with advancing PMA. Infants born at ≥32 weeks' gestation exhibited significantly higher HRV values after approximately 33 weeks' PMA than those born at <32 weeks, indicating distinct maturational trajectories according to gestational age. PMA remained independently associated with multiple HRV indices after adjustment for major clinical factors, whereas body weight z-score, respiratory support, oxygen supplementation, and caffeine exposure showed little or no independent association after adjustment. These findings characterize longitudinal 24 h HRV trajectories in preterm infants and suggest that serial 24 h HRV monitoring may provide a framework for assessing developmental changes in cardiac autonomic regulation during neonatal intensive care.
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BibTeX
@article{sugino2026longitudinal,
title = {{Longitudinal Trajectories of Autonomic Maturation in Preterm Infants Using Serial 24-Hour Heart Rate Variability Monitoring.}},
author = {Masashiro Sugino and Toru Kuboi and Yoko Tadatomo and Nana Kawaguchi and Takaaki Sadamura and Akiko Nakano and Kosuke Koyano and Shinji Nakamura and Ken Takahashi and Takashi Kusaka},
journal = {Biosensors},
year = {2026},
month = oct,
doi = {10.3390/bios16100586},
url = {https://europepmc.org/article/MED/42930133},
note = {CC BY},
}
RIS
TY - JOUR
TI - Longitudinal Trajectories of Autonomic Maturation in Preterm Infants Using Serial 24-Hour Heart Rate Variability Monitoring.
AU - Masashiro Sugino
AU - Toru Kuboi
AU - Yoko Tadatomo
AU - Nana Kawaguchi
AU - Takaaki Sadamura
AU - Akiko Nakano
AU - Kosuke Koyano
AU - Shinji Nakamura
AU - Ken Takahashi
AU - Takashi Kusaka
PY - 2026
DA - 2026/10/19
JO - Biosensors
DO - 10.3390/bios16100586
UR - https://europepmc.org/article/MED/42930133
AB - Heart rate variability (HRV) is a non-invasive measure reflecting cardiac autonomic regulation and has been used to investigate developmental changes in preterm infants. Short-term HRV recordings have demonstrated developmental changes with advancing postmenstrual age (PMA), but are highly susceptible to transient physiological conditions, limiting reproducibility. We prospectively performed serial 24 h electrocardiographic recordings in 50 preterm infants born at 24-35 weeks' gestation from postnatal life until before 37 weeks' PMA to characterize longitudinal HRV trajectories. A total of 879 recordings were analyzed using a 24 h single-window approach, and developmental trajectories were evaluated using linear mixed-effects models. All HRV indices increased progressively with advancing PMA. Infants born at ≥32 weeks' gestation exhibited significantly higher HRV values after approximately 33 weeks' PMA than those born at <32 weeks, indicating distinct maturational trajectories according to gestational age. PMA remained independently associated with multiple HRV indices after adjustment for major clinical factors, whereas body weight z-score, respiratory support, oxygen supplementation, and caffeine exposure showed little or no independent association after adjustment. These findings characterize longitudinal 24 h HRV trajectories in preterm infants and suggest that serial 24 h HRV monitoring may provide a framework for assessing developmental changes in cardiac autonomic regulation during neonatal intensive care.
SN - 2079-6374
ER -