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

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:

• watery eyes
• still-face challenge
• rhinitis
• exercise-induced asthma
• autonomic nervous system
• heart rate variability

Abbreviations

ANS, autonomic nervous system; CCCEH, Columbia Center for Children’s Environmental Health; ED, emergency department; ETS, environmental tobacco smoke; HF-HRV, high frequency variation in heart rate; HRV, heart rate variability; PR, prevalence ratio; RR, relative risk; RWWC, rhinorrhea and watery eyes without a cold.

Data Sharing Statement

A dataset specific to the results presented in this manuscript will be made available upon request after stripping identifiers prior to release. However, we believe that there remains the possibility of deductive disclosure of subjects with unusual characteristics. Thus, we will make the data and associated documentation available to users only under a data-sharing agreement that provides for (1) a commitment to using the data only for research purposes and not to identify any individual participant; (2) a commitment to securing the data using appropriate computer technology; and (3) a commitment to destroying or returning the data after analyses are completed.

Ethics Approval and Informed Consent

This study was approved by Institutional Review Boards at both Columbia University’s Medical Center and the New York State Psychiatric Institute. Mothers consented to participate and we were able to leave the study at any time.

Consent for Publication

All co-authors have reviewed this manuscript and consent to its publication.

Acknowledgments

The authors would like to thank the participating mothers and children. This work would not have been possible without the hard work and dedication of the research workers and field technicians. Data from this paper was presented at the 2019 American Academy of Asthma Allergy and Immunology as a poster presentation with interim findings. The poster’s abstract was published with other meeting abstracts in the Journal of Allergy and Clinical Immunology 2019;143;2:Supplement AB81. DOI: https://www.jacionline.org/article/S0091-6749(18)31993-6/fulltext

Author Contributions

All authors made substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data; took part in drafting the article or revising it critically for important intellectual content; agreed to submit to the current journal; gave final approval of the version to be published; and agree to be accountable for all aspects of the work.

Disclosure

The authors have no competing interests related to this manuscript.

Additional information

Funding

This work was supported by the National Institute of Health [grant numbers 5R01ES027424-02, 5UH3OD023290-04 and P30 ES009089] and the Mailman School of Public Health [pilot grant].