Inflammatory cytokine response and reduced heart rate variability in newborns with hypoxic-ischemic encephalopathy



To determine whether systemic inflammation-modulating cytokine expression is related to heart rate variability (HRV) in newborns with hypoxic-ischemic encephalopathy (HIE).

Study design:

The data from 30 newborns with HIE were analyzed. Cytokine levels (IL-2, IL-4, IL-6, IL-8, IL-10, IL-13, IL-1β, TNF-α, IFN-λ) were measured either at 24 h of cooling (n=5), 72 h of cooling (n=4) or at both timepoints (n=21). The following HRV metrics were quantified in the time domain: alpha_S, alpha_L, root mean square (RMS) at short time scales (RMS_S), RMS at long time scales (RMS_L), while low-frequency power (LF) and high-frequency power (HF) were quantified in the frequency domain. The relationships between HRV metrics and cytokines were evaluated using mixed-models.


IL-6, IL-8, IL-10, and IL-13 levels were inversely related to selected HRV metrics.


Inflammation-modulating cytokines may be important mediators in the autonomic dysfunction observed in newborns with HIE.

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We would like to thank Ms. Sophie Wohlers for her editorial assistance. We also thank Karuna Panchapakesan and Susan Knobloch for their assistance with cytokine determinations. This work was supported by the Clinical and Translational Science Institute at Children’s National (UL1TR000075 and 1KL2RR031987-01), the Intellectual and Developmental Disabilities Research Consortium (NIH P30HD040677), and the NCMRR-DC Molecular and Functional Outcome Measures in Rehabilitation Medicine Core (NICHD/NINDS 5R24HD050846-08).

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Correspondence to A N Massaro.

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Al-Shargabi, T., Govindan, R., Dave, R. et al. Inflammatory cytokine response and reduced heart rate variability in newborns with hypoxic-ischemic encephalopathy. J Perinatol 37, 668–672 (2017).

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