The Impact of Obesity on Physiologic Indicators

Obesity results in an alteration in the stress response that often results in adverse perinatal outcomes. This study investigated physiologic changes in 21 obese and 20 overweight women during pregnancy and the impact on vagal response (heart period and respiratory sinus arrhythmia), oxygenation, hemoglobin A1c (HbA1c) and systolic blood pressure at 20, 28 and 36 weeks of gestation. The impact of obesity on perinatal outcomes was investigated. Blood oxygen, systolic blood pressure, and HbA1c levels were significantly higher for the obese women as compared with overweight women. Monitoring physiologic mal-adaptation may permit early detection and intervention to improve perinatal outcomes

Cardiovascular indices (variability) predicting central nervous system maturation

As the limits of viability continue to be extended to include ever smaller and younger infants, it is increasingly apparent that more sensitive indicators are needed to quantify the level of the development of a neonate\u27s maturing central nervous system. Sympathetic and parasympathetic nervous system influences affecting heart rate exhibit changes in neural control with increasing gestational age. As the maturation pattern of the autonomic system has been documented, it may be possible to analyze individual differences in heart rate variability to serve as an indicator of the neonate\u27s neurodevelopmental level. Therefore, the purpose of the study was to investigate if there existed a pattern of neurodevelopmental maturation associated with increasing gestational age by observing heart rate variability in very preterm, preterm and fullterm infants, while controlling for behavioral state. Spectral analysis was utilized to compare the amount of spectral power derived from the electrocardiograph tracing located in specific frequency band. The results of this study concluded that there is a discernable pattern of maturation with increasing gestational age. This was demonstrated by a decreasing baseline heart rate, increasing total spectral power and a shift in the spectral power toward the higher frequency bands dominated by the parasympathetic nervous system. Behavioral state appeared to influence the amount of spectral power and heart rate variability produced as these variables increased when infants were in the sleep states. To further develop a model for maturation, more studies are needed to follow infants serially over the entire neonatal period

Cardiovascular indices (variability) predicting central nervous system maturation

As the limits of viability continue to be extended to include ever smaller and younger infants, it is increasingly apparent that more sensitive indicators are needed to quantify the level of the development of a neonate\u27s maturing central nervous system. Sympathetic and parasympathetic nervous system influences affecting heart rate exhibit changes in neural control with increasing gestational age. As the maturation pattern of the autonomic system has been documented, it may be possible to analyze individual differences in heart rate variability to serve as an indicator of the neonate\u27s neurodevelopmental level. Therefore, the purpose of the study was to investigate if there existed a pattern of neurodevelopmental maturation associated with increasing gestational age by observing heart rate variability in very preterm, preterm and fullterm infants, while controlling for behavioral state. Spectral analysis was utilized to compare the amount of spectral power derived from the electrocardiograph tracing located in specific frequency band. The results of this study concluded that there is a discernable pattern of maturation with increasing gestational age. This was demonstrated by a decreasing baseline heart rate, increasing total spectral power and a shift in the spectral power toward the higher frequency bands dominated by the parasympathetic nervous system. Behavioral state appeared to influence the amount of spectral power and heart rate variability produced as these variables increased when infants were in the sleep states. To further develop a model for maturation, more studies are needed to follow infants serially over the entire neonatal period

Core curriculum for neonatal intensive care nursing, 4th ed/ Edit.: M. Terese Verklan

xxiv, 936 hal.: ill, tab.; 28 cm

Core curriculum for neonatal intensive care nursing, 4th ed/ Edit.: M. Terese Verklan

xxiv, 936 hal.: ill, tab.; 28 cm