Objective: The purpose of this study was to compare physiologic regulation before, during, and after feeding between 15 infants with transposition of the great arteries (TGA) and 16 healthy infants matched for age, gender, and feeding type.
Methods: Data were collected post-surgically at 2 weeks and 2 months of age. High frequency heart rate variability (HF-HRV) was used as an index of physiologic regulation and examined across three phases of feeding: 30 minutes pre-feeding, during-feeding, and 60 minutes post-feeding. Data were analyzed using fixed occasions, multiple condition, linear and logistic regression analyses and event history analysis.
Results: At 2 weeks, infants with TGA demonstrated lower HF-HRV pre- and post-feeding when compared with healthy infants. Infants with TGA were less likely to demonstrate adaptive reductions in HF-HRV during-feeding and adaptive increases in HF-HRV post-feeding. Post-feeding recovery to pre-feeding HF-HRV levels was similar between groups. At 2 months, no group differences were found in HF-HRV with feeding phases. However, twice as many TGA infants as healthy infants failed to recover to pre-feeding HF-HRV levels within the post-feeding observation.
Conclusions: These findings suggest that when infants with TGA are surgically corrected and have had time to recover from surgery, physiologic regulation may be comparable to that of healthy infants. However, the prolonged recovery time observed in infants with TGA at 2 months raises questions about the equivalence of these groups. Further research in this area is needed to describe mechanisms involved in the physiologic response to feeding and its development over time.