Prone sleeping affects cardiovascular control in preterm infants in NICU

Kelsee L. Shepherd, Flora Y. Wong, Alexsandria Odoi, Emma Yeomans, Rosemary S.C. Horne, Stephanie R. Yiallourou

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background: Prone sleeping is used in preterm infants undergoing intensive care to improve respiratory function, but evidence suggests that this position may compromise autonomic cardiovascular control. To test this hypothesis, this study assessed the effects of the prone sleeping position on cardiovascular control in preterm infants undergoing intensive care treatment during early postnatal life. Methods: Fifty-six preterm infants, divided into extremely preterm (gestational age (GA) 24–28 weeks, n = 23) and very preterm (GA 29–34 weeks, n = 33) groups, were studied weekly for 3 weeks in prone and supine positions, during quiet and active sleep. Heart rate (HR) and non-invasive blood pressure (BP) were recorded and autonomic measures of HR variability (HRV), BP variability (BPV), and baroreflex sensitivity (BRS) using frequency analysis in low (LF) and high (HF) bands were assessed. Results: During the first 3 weeks, prone sleeping increased HR, reduced BRS, and increased HF BPV compared to supine. LF and HF HRV were also lower prone compared to supine in very preterm infants. Extremely preterm infants had the lowest HRV and BRS measures, and the highest HF BPV. Conclusions: Prone sleeping dampens cardiovascular control in early postnatal life in preterm infants, having potential implications for BP regulation in infants undergoing intensive care.

Original languageEnglish
Pages (from-to)197-204
Number of pages8
JournalPediatric Research
Volume90
Issue number1
DOIs
Publication statusPublished - Jul 2021

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