BRIEF RESEARCH REPORT article
Front. Pediatr.
Sec. Neonatology
Volume 13 - 2025 | doi: 10.3389/fped.2025.1579197
Heart rate variability and amplitude-integrated electroencephalography measured shortly after birth and time to reach clinical milestones: a pilot study in late preterm infants
Provisionally accepted
Birju A. Shah1*
Samantha Latremouille2
Sanjay Chawla3
Martin Keszler4
Richard Tucker4
Abbot Laptook4
GUILHERME M SANT'ANNA2- 1University of Oklahoma Health Sciences Center, Oklahoma City, United States
- 2McGill University Health Centre, Montreal, Quebec, Canada
- 3Wayne State University, Detroit, Michigan, United States
- 4Warren Alpert Medical School, Brown University, Providence, Rhode Island, United States
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background: Amongst late preterm infants, there is significant variability in reaching milestones for safe discharge. We examined the associations of early measures of heart rate variability (HRV) and amplitude integrated electroencephalogram (aEEG) with time to wean to an open-air cot and to achieve full oral feeds. Methods: Prospective, multi-center observational cohort that enrolled infants between 34 0/7 -and 34 6/7 -weeks gestational age (GA). Infants with growth restriction and major congenital anomaly were excluded. Electrocardiogram (ECG) for an hour and cross-cerebral aEEG for 6 hours were recorded within 96 hours after birth. Correlations of HRV and aEEG parameters with outcomes were evaluated using stepwise linear regression. Results: Of the 26 infants from 3 centers, 23 were included for analysis for time to an open-air cot. For time to full oral feeds, the analysis was limited to 19 infants from 2 centers with similar feeding policies. Including HRV parameters (time domain -median and standard deviation of R-wave to R-wave interval, frequency domain -ratio of the low frequency to high frequency power, and their interaction) and aEEG parameters (total and immature cycles per hour) strengthened associations with time to open-air cot (adjusted R2 0.72) and time to full oral feeds (adjusted R2 0.53) compared to each parameter alone. Conclusions: Early measurements of HRV and aEEG parameters correlate with time to an open-air cot and to the establishment of full oral feeds in late preterm infants born between 34 0/7 -34 6/7 weeks GA.
Keywords: biomarkers, neurophysiologic assessment, length of hospital admission, developmental maturation, Clinical milestones, Neonatal morbidities, Late preterm babies
Received: 18 Feb 2025; Accepted: 15 May 2025.
Copyright: © 2025 Shah, Latremouille, Chawla, Keszler, Tucker, Laptook and SANT'ANNA. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Birju A. Shah, University of Oklahoma Health Sciences Center, Oklahoma City, United States
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.