Key result
Primary caesarean section linked to ~142% higher odds of prolonged QTc in neonates versus spontaneous delivery.
Why the study?
The study was conducted to evaluate the influence of the mode of delivery on repolarisation and the QT interval in the neonatal ECG.
Does primary caesarean section increase neonatal QTc compared to spontaneous delivery in neonates?
Cohort (n=712)
Blinded outcome assessment
No
Does primary caesarean section increase neonatal QTc compared to spontaneous delivery in neonates?
Effect estimate: OR 2.421 (95% CI 1.031-5.681)
Absolute Event Rate: 9.1% vs 4.3%
p-value: p=0.042
Primary caesarean section is associated with a significantly higher mean QTc and an increased rate of prolonged QTc >450 ms in neonates compared to spontaneous delivery, suggesting delivery mode should be considered in postnatal risk assessment.
May warrant considering delivery mode in neonatal QTc assessment; extends evidence but leaves causality open.
Objective To evaluate the influence of mode of delivery on repolarisation and QT interval in the neonatal electrocardiogram (ECG). Study design KUNO-Kids is a prospective, population-based birth cohort study. Neonates received an ECG within the first week of life; subgroups were divided according to mode of delivery. Effects on neonatal QT interval were tested by linear and logistic regression analyses, adjusting for age at ECG recording. Results In total, 712 neonates were included. The primary caesarean section group showed a significant higher mean QTc (regression coefficient 6.03, p = 0.033) and a significantly increased rate of prolonged QTc >450 ms (odds ratio 2.4, p = 0.042), compared to the spontaneous delivery group. Conclusion The mode of delivery has a significant effect on neonatal QTc. Clinicians should consider this influence when deciding on postnatal and follow-up examinations, regarding additional risk factors for acquired long QT interval.
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Eder et al. (2026) conducted a cohort in Neonatal QTc prolongation (n=712). Primary caesarean section vs. Spontaneous delivery was evaluated on Prolonged QTc >450 ms (OR 2.421, 95% CI 1.031-5.681, p=0.042). Primary caesarean section significantly increased the rate of prolonged QTc >450 ms (OR 2.421) and mean QTc compared to spontaneous delivery in neonates.
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