Key result
Dry-electrode ECG sensor reliably captures newborn heart rate within ~3 seconds after birth.
Why the study?
There is limited evidence regarding normal heart rate during the first minutes of life and its changes immediately following delivery.
How does the normal newborn heart rate change in the first five minutes of life when assessed by dry-electrode electrocardiography?
Observational (n=55)
How does the normal newborn heart rate change in the first five minutes of life when assessed by dry-electrode electrocardiography?
A dry-electrode ECG sensor can reliably detect heart rate immediately after birth, demonstrating that normal newborn heart rate increases significantly during the first minute of life.
Early post-delivery ECG HR monitoring is feasible; leaves open optimal thresholds for guiding resuscitation in the first minute of life.
BACKGROUND: There is limited evidence regarding the heart rate (HR) during the first minutes of life. Nonetheless, resuscitative actions within the first minute are partly guided by different HR levels. The advent of an electrocardiographic (ECG) HR sensor with early HR detection has provided the opportunity to study changes immediately following delivery. OBJECTIVE: The objectives were to determine immediately following delivery: (i) the time to achievement of reliable ECG signals using dry electrodes, (ii) changes in HR, and (iii) the influence of the onset of breathing and cord clamping on the HR. METHODS: Healthy term neonates were randomly included between July and October 2013. The HR was recorded by the ECG sensor, placed over the abdomen immediately after birth. RESULTS: Fifty-five newborns were included. The median time from birth to placement of the HR sensor was 3 s (quartiles: 2 and 5), and the median time to the start of breathing was 6 s (quartiles: 2 and 15). The HR was around 120 beats/min (bpm) in the first seconds of life. As determined via breakpoint analysis, the HR increased by 1 beat in the first 40 s to 149 ± 33 bpm, followed by a moderate increase until 130 s and stabilization thereafter. After the onset of breathing, the HR decreased for 10 s and then increased. Minimal HR changes were observed after cord clamping. CONCLUSION: A dry-electrode ECG sensor detected reliable ECG signals almost immediately after birth. The normal HR increased significantly in spontaneously breathing infants during the first minute, influenced by the onset of breathing. Delayed cord clamping had a minimal impact on the HR, likely reflecting an earlier onset of breathing.
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Linde et al. (2016) conducted an observational in Healthy term neonates (n=55). Dry-electrode electrocardiography (ECG) sensor was evaluated on Time to achievement of reliable ECG signals and changes in heart rate. Assessment using a dry-electrode ECG sensor showed reliable signals within a median of 3 seconds and a normal newborn heart rate increase to 149 ± 33 bpm in the first 40 seconds of life.