Significance of Neonatal Heart Rate in the Delivery Room-A Review.
electrocardiogram
heart rate
infants
neonatal resuscitation
newborn
pulse oximetry
Journal
Children (Basel, Switzerland)
ISSN: 2227-9067
Titre abrégé: Children (Basel)
Pays: Switzerland
ID NLM: 101648936
Informations de publication
Date de publication:
14 Sep 2023
14 Sep 2023
Historique:
received:
16
08
2023
revised:
08
09
2023
accepted:
12
09
2023
medline:
28
9
2023
pubmed:
28
9
2023
entrez:
28
9
2023
Statut:
epublish
Résumé
Heart rate (HR) is considered the main vital sign in newborns during perinatal transition, with a threshold of 100 beats per minute (bpm), below which, intervention is recommended. However, recent changes in delivery room management, including delayed cord clamping, are likely to have influenced normal HR transition. To summarize the updated knowledge about the factors, including measurement methods, that influence HR in newborn infants immediately after birth. Additionally, this paper provides an overview of delivery room HR as a prognostic indicator in different subgroups of newborns. We searched PubMed, EMBASE, and Google Scholar with the terms infant, heart rate, delivery room, resuscitation, pulse oximetry, and electrocardiogram. Seven studies that described HR values in newborn infants immediately after birth were included. Pulse oximetry-derived HR percentiles after immediate cord clamping may not be applicable to the current practice of delayed cord clamping and the increasing use of delivery room electrocardiograms. Mask ventilation may adversely affect HR, particularly in premature and non-asphyxiated infants. Prolonged bradycardia is a negative prognostic factor, especially if combined with hypoxemia in infants <32 weeks of gestation. HR assessment in the delivery room remains important. However, the cardiopulmonary transition is affected by delayed cord clamping, gestational age, and underlying conditions.
Sections du résumé
BACKGROUND
BACKGROUND
Heart rate (HR) is considered the main vital sign in newborns during perinatal transition, with a threshold of 100 beats per minute (bpm), below which, intervention is recommended. However, recent changes in delivery room management, including delayed cord clamping, are likely to have influenced normal HR transition.
OBJECTIVE
OBJECTIVE
To summarize the updated knowledge about the factors, including measurement methods, that influence HR in newborn infants immediately after birth. Additionally, this paper provides an overview of delivery room HR as a prognostic indicator in different subgroups of newborns.
METHODS
METHODS
We searched PubMed, EMBASE, and Google Scholar with the terms infant, heart rate, delivery room, resuscitation, pulse oximetry, and electrocardiogram.
RESULTS
RESULTS
Seven studies that described HR values in newborn infants immediately after birth were included. Pulse oximetry-derived HR percentiles after immediate cord clamping may not be applicable to the current practice of delayed cord clamping and the increasing use of delivery room electrocardiograms. Mask ventilation may adversely affect HR, particularly in premature and non-asphyxiated infants. Prolonged bradycardia is a negative prognostic factor, especially if combined with hypoxemia in infants <32 weeks of gestation.
CONCLUSIONS
CONCLUSIONS
HR assessment in the delivery room remains important. However, the cardiopulmonary transition is affected by delayed cord clamping, gestational age, and underlying conditions.
Identifiants
pubmed: 37761512
pii: children10091551
doi: 10.3390/children10091551
pmc: PMC10528538
pii:
doi:
Types de publication
Journal Article
Review
Langues
eng
Références
Circulation. 2015 Nov 3;132(18 Suppl 2):S543-60
pubmed: 26473001
Resuscitation. 2017 Jul;116:66-72
pubmed: 28427883
Acta Paediatr. 2023 Apr;112(4):697-705
pubmed: 36607256
Arch Dis Child Fetal Neonatal Ed. 2021 May;106(3):311-315
pubmed: 33172876
Acta Paediatr. 2005 Jul;94(7):890-5
pubmed: 16188811
Arch Dis Child Fetal Neonatal Ed. 2018 Sep;103(5):F446-F454
pubmed: 28988158
J Pediatr. 2015 Jan;166(1):49-53
pubmed: 25444526
Indian Pediatr. 2003 Jun;40(6):510-7
pubmed: 12824660
Resuscitation. 2021 Jul;164:62-69
pubmed: 34048860
Resuscitation. 2004 Feb;60(2):213-7
pubmed: 15036740
Resuscitation. 2013 Mar;84(3):369-72
pubmed: 22925993
Arch Dis Child Fetal Neonatal Ed. 2011 Mar;96(2):F102-7
pubmed: 21126997
Resuscitation. 2021 Oct;167:209-217
pubmed: 34425156
Pediatrics. 1998 Jul;102(1):e1
pubmed: 9651453
Pediatr Res. 1993 Dec;34(6):809-12
pubmed: 8108199
Arch Dis Child Fetal Neonatal Ed. 2014 Jul;99(4):F309-14
pubmed: 24688080
Am J Perinatol. 2020 Jun;37(7):738-744
pubmed: 31146295
Circulation. 2020 Oct 20;142(16_suppl_1):S185-S221
pubmed: 33084392
PLoS Med. 2022 Jun 23;19(6):e1004029
pubmed: 35737735
Matern Health Neonatol Perinatol. 2019 May 30;5:7
pubmed: 31161042
Arch Dis Child Fetal Neonatal Ed. 2021 Jul;106(4):381-385
pubmed: 33298407
Arch Dis Child Fetal Neonatal Ed. 2016 Nov;101(6):F540-F545
pubmed: 27059073
Arch Dis Child. 2018 Mar;103(3):255-260
pubmed: 28912163
J Pediatr. 2008 Jun;152(6):756-60
pubmed: 18492509
Pediatr Res. 2015 May;77(5):608-14
pubmed: 25671807
Pediatrics. 2012 Nov;130(5):e1177-81
pubmed: 23090347
Arch Dis Child. 1993 Jan;68(1 Spec No):11-6
pubmed: 8439189
Pediatr Int. 2012 Apr;54(2):205-7
pubmed: 22044505
J Paediatr Child Health. 2008 May;44(5):273-5
pubmed: 17999668
J Pediatr. 2013 Dec;163(6):1553-1557.e1
pubmed: 23866717
Pediatrics. 2009 Sep;124(3):e439-49
pubmed: 19661049
J Matern Fetal Neonatal Med. 2016;29(10):1570-2
pubmed: 26103783
Resuscitation. 2019 Nov;144:178-184
pubmed: 31521774
Circulation. 2013 Dec 3;128(23):2532-41
pubmed: 24297818
Acta Paediatr. 2023 Aug;112(8):1648-1652
pubmed: 37151193
Resuscitation. 2006 Dec;71(3):319-21
pubmed: 16989935
Pediatrics. 2010 Jun;125(6):e1340-7
pubmed: 20439604
Arch Dis Child Fetal Neonatal Ed. 2018 Nov;103(6):F530-F538
pubmed: 29191812
Arch Dis Child Fetal Neonatal Ed. 2020 Nov;105(6):675-679
pubmed: 32350064
Arch Dis Child Fetal Neonatal Ed. 2010 May;95(3):F177-81
pubmed: 20444810
J Pediatr. 2006 May;148(5):569-70
pubmed: 16737860
BMJ Paediatr Open. 2023 Apr;7(1):
pubmed: 37028906