Heart rate variability (HRV), a measure of cardiac autonomic control, was analyzed in infants to assess the hypothesis that early undernutrition may induce autonomic dysfunction that could play a role in the programming of later cardiovascular disease. HRV data were collected during a night session in 546 healthy infants at 5–12 weeks of adjusted age, and statistical associations with fetal and postnatal growth indices were established. A significant positive correlation between birth weight, the ratio of neonatal weight to head circumference and postnatal weight gain, and HRV indices mostly influenced by sympathetic activity was demonstrated in 11- and 12-week-old infants. A slight correlation (p > 0.05) was also found in younger infants. These data suggest the influence of fetal and postnatal growth on the programming of the autonomic nervous system beyond the neonatal period. This influence may be one of the important mechanisms that link impaired growth in fetal and infant life to high blood pressure and other cardiovascular disease during childhood and adulthood (the Barker hypothesis).

Keywords:
Heart rate variability, Infants, Pathophysiology, Epidemiology, Cardiovascular disease
1.
Barker DJP: Fetal origins of coronary heart disease. BMJ 1995;311:171–174.
2.
Paneth N, Susser M: Early origin of coronary heart disease (the ‘Barker hypothesis’). BMJ 1995;310:411–412.
3.
Law CM, Shiell AW: Is blood pressure inversely related to birth weight? The strength of evidence from a systematic review of the literature. J Hypertens 1996;14:935–941.
4.
Barker DJP, Gluckman PD, Godfrey KM, Harding JE, Owens JA, Robinson JS: Fetal nutrition and cardiovascular disease in adult life. Lancet 1993;341:938–941.
5.
Barker DJP, Hales CN, Fall CHD, Osmond C, Phipps K, Clark PMS: Type 2 (non-insulin-dependent) diabetes mellitus, hypertension and hyperlipidaemia (syndrome X): Relation to reduced fetal growth. Diabetologia 1993;36:62–67.
6.
Forrester TE, Wilks RJ, Bennett FI, Simeon D, Osmond C, Allen M, Chung AP, Scott P: Fetal growth and cardiovascular risk factors in Jamaican schoolchildren. BMJ 1996;312:156–160.
7.
Martyn CN, Meade TW, Stirling Y, Barker DJP: Plasma concentrations of fibrinogen and factor VII in adult life and their relation to intra-uterine growth. Br J Haematol 1995;89:142–146.
8.
Launer LJ, Hofman A, Grobbee DE: Relation between birth weight and blood pressure: Longitudinal study of infants and children. BMJ 1993;307:1451–1454.
9.
Law CM, de Swiet M, Osmond C, Fayers PM, Barker DJP, Cruddas AM, Fall CHD: Initiation of hypertension in utero and its amplification throughout life. BMJ 1993;306:24–27.
10.
Hashimoto N, Kawasaki T, Kikuchi T, Takahashi H, Uchiyama M: The relationship between the intrauterine environment and blood pressure in 3-year-old Japanese children. Acta Paediatr 1996;85:132–138.
11.
Martyn CN, Barker DJP, Jespersen S, Greenwald S, Osmond C, Berry C: Growth in utero, adult blood pressure and arterial compliance. Br Heart J 1995;73:116–121.
12.
Brenner BM, Chertow GM: Congenital oligonephropathy and the etiology of adult hypertension and progressive renal injury. Am J Kidney Dis 1994;23:171–175.
13.
Bourre J, Morand O, Chanez C, Dumont O, Flexor M: Influence of intrauterine malnutrition on brain development: Alteration of myelination. Biol Neonate 1981;39:96–99.
14.
Chanez C, Adrien J: Effect of intrauterine growth retardation on brain development and sleep in the developing rats; in Koella WP, Ruther E, Schulz H (eds): Sleep 84. New York, Fischer, 1984, pp 101–104.
15.
Larroche JC, Korn G: Brain damage in intrauterine growth retardation; in Gluck L (ed): Intrauterine Asphyxia and the Developing Fetal Brain. Chicago, Year Book Medical Publishers, 1977, pp 25–35.
16.
Widdowson EM, McCance RA: A review: New thoughts on growth. Pediatr Res 1975;9:154–156.
17.
Edwards CRW, Benediktsson R, Lindsay RS, Seckl JR: Dysfunction of placental glucocorticoid barrier: Link between fetal environment and adult hypertension? Lancet 1993;341:355–357.
18.
Langley SC, Jackson AA: Increased systolic blood pressure in adult rats induced by fetal exposure to maternal low protein diets. Clin Sci (Colch) 1994;86:217–222.
19.
Schulze K, Kairam R, Stefanski M, Sciacca R, Bateman D, Dell R, James L: Spontaneous variability in minute ventilation, oxygen consumption and heart rate of low birth weight infants. Pediatr Res 1981;15:1111–1116.
20.
Butte NF, Jensen CL, Moon JK, Glaze DG, Frost JD: Sleep organization and energy expenditure of breast-fed and formula-fed infants. Pediatr Res 1992;32:514–519.
© 2001 S. Karger AG, Basel
2001
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.