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. 2021 Nov 9:14:1349-1354.
doi: 10.2147/JAA.S329347. eCollection 2021.

Increased Heart Rate Variability Response Among Infants with Reported Rhinorrhea and Watery Eyes: A Pilot Study

Laura A Conrad  1 , Natalie Buchinsky  2 , Luis M Acosta  2 , J David Nugent  3 , Khalil W Savary  4 , Rachel L Miller  5 , Nurdant Emanet  6 , Julie Herbstman  2 , Beatrice Beebe  6 , Michael M Myers  3 , William P Fifer  3 , Matthew S Perzanowski  2
Affiliations

Increased Heart Rate Variability Response Among Infants with Reported Rhinorrhea and Watery Eyes: A Pilot Study

Laura A Conrad et al. J Asthma Allergy. .

Abstract

Introduction: Previously, we found that reported infant rhinorrhea and watery eyes without a cold (RWWC) predicted school age exercise-induced wheeze, emergency department visits, and hospitalizations. These findings were independent of allergic sensitization, and we theorized that increased parasympathetic tone underlay the association. We also reported that increased heart-rate variability (HRV) in infants predicted wheeze in 2-3 year-olds. In a convenience sample of children participating in a birth cohort study, we tested the hypothesis that infants with RWWC would have elevated HRV, indicating increased parasympathetic tone.

Methods: RWWC symptoms since birth were queried for 3-month-old children. At 4-months, HRV was assessed (root mean square of successive differences [RMSSD]) during a standardized infant-mother still-face paradigm, which included 2 minutes of mother/child play immediately followed by 2 minutes of the mother maintaining a still-face.

Results: Among participants (n=38), RWWC was common for girls (32%) and boys (21%). The children with the greatest decrease in RMSSD between play and still-face challenge (lowest tertile) had a higher prevalence of RWWC as compared with children in the higher tertiles (50% vs 16%, P=0.045). In a logistic regression model controlling for sex, age and time between HRV and RWWC assessment, children with greater decrease in HRV between play and still-face (lowest tertile) had greater odds of having RWWC (odds ratio=6.0, P=0.029).

Conclusion: In this relatively small study, we demonstrated greater decreases in HRV in response to a stressor among children with reported RWWC, suggesting that these children might have increased parasympathetic tone and/or overall greater vagal reactivity.

Keywords: autonomic nervous system; exercise-induced asthma; heart rate variability; rhinitis; still-face challenge; watery eyes.

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Conflict of interest statement

The authors have no competing interests related to this manuscript.

Figures

Figure 1
Figure 1
Prevalence of rhinorrhea/watery eyes without colds (RWWC) at age 3 months by tertile of change in heart rate variability (root mean square of the successive differences: RMSSD) measured between play and still-face challenge (n=38). Children with the greatest decrease in HRV were the most likely to have had a report of RWWC.
Figure 2
Figure 2
Hypothesized connection between autonomic dysregulation in infancy and airway hyperreactivity at school age. Components tested in this analysis are shown in red.
See this image and copyright information in PMC

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