Heart Rate Characteristics and Neurodevelopmental Outcome in Very Low Birth Weight Infants

Abstract

Sepsis in very low birth weight (VLBW) infants has been associated with an increased risk of adverse developmental outcome. We have identified abnormal heart rate characteristics (HRCs) that are predictive of impending sepsis, and we have developed a summary measure of an infant’s HRCs during the neonatal hospitalization that we refer to as the cumulative HRC score (cHRC). In this study we tested the hypothesis that increasing cHRC is associated with an increasing risk of adverse neurodevelopmental outcome in VLBW infants. Data were collected on 65 VLBW infants whose HRCs were monitored while in the neonatal intensive care unit and who were examined at 12-18 months adjusted age. Using a standard neurological exam and the Bayley Scale of Infant Development-II, we identified cerebral palsy (CP) and delays in early cognitive function and psychomotor development. Increasing cHRC score was associated with an increased risk of CP [odds ratio: 2.6, (1.42, 5.1)] and delayed early cognitive development [odds ratio: 2.3 (1.3; 4.3)]. These associations remain statistically significant when adjusted for major cranial ultrasound abnormality. In conclusion, the cHRC score is associated with an increased risk of adverse neurodevelopmental outcome among VLBW infants.