To characterize the differences in baroreflex sensitivity (BRS), blood pressure (BP), heart rate (HR) and respiration rate (RR) in preterm infants with a similar postconceptional age reached by various combinations of gestational and postnatal ages. To detect potential sex differences in assessed cardiovascular parameters. The study included 49 children (24 boys and 25 girls), postconceptional age 34.6±1.9 weeks. Two subgroups of infants were selected with the similar postconceptional age (PcA) and current weight, but differing in gestational (GA) and postnatal (PnA) ages, as well as two matched subgroups of boys and girls. Blood pressure (BP) was recorded continuously using Portapres device (FMS). A stationary segment of 250 beat-to-beat BP values was analyzed for each child. Baroreflex sensitivity (BRS) was calculated by cross-correlation sequence method. Despite the same PcA age and current weight, children with longer GA had higher BRS, diastolic and mean BP than children with shorter GA and longer PnA age. Postconceptional age in preterm infants is a parameter of maturation better predicting baroreflex sensitivity and blood pressure values compared to postnatal age. Sex related differences in BRS, BP, HR and RR were not found in our group of preterm infants.
Phototherapy is the most effective non-invasive method of neonatal hyperbilirubinemia treatment. Application of this method can be associated with side effects including changes in the cardiovascular system. During phototherapy, the primary effects in the cardiovascular system include cutaneous vasodilation leading to skin hyperperfusion and subsequent redistribution of blood. The increased blood flow through the skin is associated with increased transepidermal water loss. Further effects include an increase in cerebral blood flow. Redistribution of blood to the cutaneous bed is compensated by hypoperfusion in the splanchnic area (mostly postprandial) and a significant reduction of the renal blood flow. Regarding closure/reopening of the ductus arteriosus, the results suggest that that phototherapy does not affect ductal patency. During phototherapy the cardiac output can be slightly reduced due to a decreased stroke volume, especially in preterm newborns. Systemic blood pressure is decreased and heart rate is elevated in both preterm and term newborns during phototherapy. The heart rate variability is slightly reduced. Symbolic dynamics analysis of the short-term HRV showed that during phototherapy the activity of the ANS regulating the heart rate is shifted towards the dominancy of the sympathetic activity. The responses in the cardiovascular system of premature/mature newborns without other pathology confirm a well physiologically functioning control of this system, even under specific conditions of phototherapy.