Electrocardiographic Characteristics of Healthy Newborns During the First Postnatal Hour

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Healthy newborns (n=260). Intervention: First postnatal hour transition. Primary outcome: Electrocardiographic parameter variations.

Q: What does this research mean for the field?

Healthy newborns demonstrate physiologic electrocardiographic variations during the first postnatal hour, including right axis deviation (1.5%), left axis deviation (1.2%), and low atrial rhythm (0.3%). Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Duygu Acar; Erkut Öztürk

doi:10.3390/jcdd13030140

March 17, 2026Journal of Cardiovascular Development and DiseaseOpen Access

Electrocardiographic Characteristics of Healthy Newborns During the First Postnatal Hour

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Key result

Neonatal ECGs reveal benign electrical variations, including axis deviation, within the first postnatal hour.

n=260

Why the study?

Few studies have reported electrocardiogram data collected during the neonatal period.

Key Points

To evaluate electrocardiographic parameters and identify baseline electrical variations in healthy neonates during the first postnatal hour.
Prospective observational study evaluating healthy newborns delivered at a single hospital between November 1, 2023, and February 1, 2024 (N = 260).
Electrocardiograms were obtained during the first hour of life, with demographic, physical examination, and predischarge echocardiographic findings collected for all included neonates.
Infants requiring resuscitation, those with congenital anomalies, advanced preterm infants, and those admitted to the neonatal intensive care unit were excluded.
Among 260 included neonates (50% male [n = 130], mean gestational age 38.1 ± 1.4 weeks, mean birth weight 3.2 ± 1.4 kg), low atrial rhythm was detected in 0.3% (n = 1), right axis deviation in 1.5% (n = 4), and left axis deviation in 1.2% (n = 3).
An abnormal P-axis was observed in 0.3% of patients (n = 1) and an abnormal QRS-T angle in 0.3% (n = 1), with no statistically significant differences observed in other electrocardiographic parameters.

Study Design

Type

Observational (n=260)

Multicenter

No

Structured PICO

P

Population

260 healthy neonates (mean gestational age 38.1 weeks) underwent electrocardiography during the first postnatal hour to describe normal physiological parameters.

E

Exposure

12-lead electrocardiogram (ECG) performed during the first postnatal hour (median time 25 minutes after birth).

O

Outcome

Electrocardiographic parameters during the first postnatal hour (including rhythm, heart rate, axes, intervals, and wave amplitudes/orientations).surrogate

Descriptive electrocardiographic data recorded during the first postnatal hour help define physiologic transitional patterns, allowing clinicians to better distinguish normal variations from pathologic abnormalities in newborns.

Limitations

Single-center study with a limited number of patients
All recordings were performed by the same team, lacking interobserver variability analysis
Echocardiography could not be performed immediately in the early period
High rate of Cesarean sections where anesthesia drugs might affect ECGs
Comparisons were made with historical reference data (Davignon et al.) which may be influenced by racial and ethnic factors
Conducted in a single center with a limited number of patients
All recordings performed by the same team
Inability to perform echocardiography immediately in the early period
High Cesarean section rate, where anesthesia drugs might affect ECGs
Racial and ethnic factors may have influenced results in comparison to historical datasets

Implication

May aid differentiation of normal from pathologic neonatal ECGs in the first hour; extends sparse observational data but remains hypothesis-generating.

Abstract

Background: Few studies have reported electrocardiogram data collected during the neonatal period. The aim of this study was to evaluate electrocardiographic parameters in healthy neonates during the first postnatal hour. Methods: Electrocardiogram samples taken during the first hour of life from newborns born at our hospital were analyzed in this prospective observational study. Demographic data and possible electrocardiogram changes were studied. The results were statistically analyzed. Results: A total of 260 patients were included during the study period. Among these, 50% were male (n = 130), the mean gestational age was 38.1 ± 1.4 weeks, and the mean birth weight was 3.2 ± 1.4 kg. In the electrocardiograms obtained, low atrial rhythm was detected in 0.3% of the patients (n = 1). Right axis deviation was observed in 1.5% of the patients (n = 4), and left axis deviation was observed in 1.2% of the patients (n = 3). An abnormal P-axis was found in one patient (0.3%), and an abnormal QRS-T angle was found in one patient (0.3%). No statistically significant differences were observed in the other parameters. Conclusion: Physiologic electrocardiographic findings can be observed during the first postnatal hour. Further studies are needed to clarify the interpretation of the electrocardiogram findings.

Discussion

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Cite This Study

Acar et al. (2026) conducted an observational in Healthy newborns (n=260). First postnatal hour transition was evaluated on Electrocardiographic parameter variations. During the first postnatal hour, physiologic electrocardiographic variations are observable in healthy neonates, including right axis deviation (1.5%), left axis deviation (1.2%), and low atrial rhythm (0.3%).

synapsesocial.com/papers/69bb92ae496e729e629802d4 https://doi.org/10.3390/jcdd13030140

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Bookmark

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Electrocardiographic Characteristics of Healthy Newborns During the First Postnatal Hour

Key Points

Study Design

Structured PICO

Limitations

Implication

Abstract

Discussion

Cite This Study

Electrocardiographic Characteristics of Healthy Newborns During the First Postnatal Hour

Key Points

Study Design

Structured PICO

Limitations

Implication

Abstract

Discussion

Cite This Study

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