Tactile Stimulation and Newborn Heart Rate Responses in the Delivery Room: An Observational Video Study

Aims: Newborn resuscitation guidelines recommend stimulation as a first step in nonbreathing newborns to facilitate spontaneous breathing.We aimed to evaluate the extent of stimulation in the delivery room, heart rate (HR) responses to stimulation, and association between bradycardia (HR <100 beats per minute (bpm) 10 seconds) in the first minute after birth and the need for positive pressure ventilation (PPV) versus stimulation alone. Method: A prospective observational study conducted at tertiary level Stavanger UniversityHospital, Norway, September 2022 -July 2024 including newborns with gestational age 34 weeks.Stimulation was registered from thermal videos in the delivery room and visible light cameras over resuscitaires.HR was obtained using dry-electrode ECG.Results: 449 included newborns had thermal videos visible light video and HR data.70/449 (16%) newborns did not receive any resuscitative interventions, 345/449 (77%) received stimulation alone, 14/449 (3.1%) received continuous positive airway pressure, and 20/449 (4.4%) received PPV.We observed a HR increase of median 7 bpm among newborns with HR <140 bpm at start stimulation (p<0.001).Newborns with bradycardia in the first minute after birth had four-fold likelihood of requiring PPV versus tactile stimulation alone.p=0.009). Conclusion:Tactile stimulation is widely applied during neonatal transition.We observed an increase in HR in relation to tactile stimulation, especially among newborns with HR <140 bpm at start stimulation.Newborns with bradycardia (HR <100 bpm 10 seconds) in the first minute after birth had a four-fold likelihood of requiring PPV versus tactile stimulation alone.