Effect of sleeping position on cardiac output, pulmonary pressure, and superior vena cava flow in healthy term infants

Background

Although the mechanism of action in newborns is unknown, sleep positioning is associated with many pathophysiological events. This study aimed to compare the effects of supine and prone sleeping positions on cardiac output (CO), systolic pulmonary arterial pressure (SPAP), and superior vena cava (SVC) flow in healthy newborns.

Methods

In the first 24–72 h of life, 40 healthy term newborns born in the same hospital were included in this prospective, cross-sectional, observational study. CO, SVC flow, and SPAP values of newborns in the supine and prone sleeping positions were calculated using echocardiographic examination. The measurements were statistically compared.

Results

In the supine sleeping position, CO, SVC flow, and SPAP were 235.00 (193.07–283.30) ml/kg/min, 92.80 (77.82–121.87) ml/kg/min, and 27.85 (24.70–30.48) mmHg. In the prone sleeping position, CO, SVC flow, and SPAP were measured as 195.35 (166.00–229.40) ml/kg/min, 67.25 (51.82–96.66) ml/kg/min, 31.60 (28.45–37.20) mmHg, respectively. Depending on sleeping position, these variables were significantly different between the groups.

Conclusion

SVC flow and CO decreased in the prone sleeping position compared to the supine sleeping position in healthy newborns, whereas SPAP increased. The different hemodynamic effects of sleeping position on the cardiac, pulmonary, and nervous systems should be considered as flow and pressure changes are important in newborns.