| 1. |
- KC, Ashish, 1982-, et al.
(författare)
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Increased risk of bradycardia in vigorous infants receiving early as compared to delayed cord clamping at birth
- 2023
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Ingår i: Journal of Perinatology. - : Springer Nature. - 0743-8346 .- 1476-5543. ; 43, s. 709-715
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveTo compare HR pattern of vigorous newborns during the first 180 s with early (≤60 s, ECC) or delayed (>60 s, DCC) cord clamping.Study designObservational study including dry-electrode ECG monitoring of 610 vaginally-born singleton term and late-preterm (≥34 weeks) who were vigorous after birth.Results198 received ECC while 412 received DCC with median cord clamping at 37 s and 94 s. Median HR remained stable from 30 to 180 s with DCC (172 and 170 bpm respectively) but increased with ECC (169 and 184 bpm). The proportion with bradycardia was higher among ECC than DCC at 30 s and fell faster in the DCC through 60 s. After adjusting for factors affecting timing of cord clamping, ECC had significant risk of bradycardia compared to DCC (aRR 1.51; 95% CI; 1.01–2.26).ConclusionEarly heart instability and higher risk of bradycardia with ECC as compared to DCC supports the recommended clinical practice of DCC.
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| 2. |
- KC, Ashish, 1982, et al.
(författare)
-
Increased risk of bradycardia in vigorous infants receiving early as compared to delayed cord clamping at birth.
- 2023
-
Ingår i: Journal of perinatology : official journal of the California Perinatal Association. - : Springer Science and Business Media LLC. - 1476-5543 .- 0743-8346. ; 43:6, s. 709-715
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Tidskriftsartikel (refereegranskat)abstract
- To compare HR pattern of vigorous newborns during the first 180 s with early (≤60 s, ECC) or delayed (>60 s, DCC) cord clamping.Observational study including dry-electrode ECG monitoring of 610 vaginally-born singleton term and late-preterm (≥34 weeks) who were vigorous after birth.198 received ECC while 412 received DCC with median cord clamping at 37 s and 94 s. Median HR remained stable from 30 to 180 s with DCC (172 and 170 bpm respectively) but increased with ECC (169 and 184 bpm). The proportion with bradycardia was higher among ECC than DCC at 30 s and fell faster in the DCC through 60 s. After adjusting for factors affecting timing of cord clamping, ECC had significant risk of bradycardia compared to DCC (aRR 1.51; 95% CI; 1.01-2.26).Early heart instability and higher risk of bradycardia with ECC as compared to DCC supports the recommended clinical practice of DCC.
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| 3. |
- Kukka, Antti, et al.
(författare)
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Observational study comparing heart rate in crying and non-crying but breathing infants at birth
- 2023
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Ingår i: BMJ Paediatrics Open. - : BMJ Publishing Group Ltd. - 2399-9772. ; 7:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Stimulating infants to elicit a cry at birth is common but could result in unnecessary handling. We evaluated heart rate in infants who were crying versus non-crying but breathing immediately after birth.Methods: This was single-centre observational study of singleton, vaginally born infants at = 33 weeks of gestation. Infants who were crying or non-crying but breathing within 30 s after birth were included.Background: demographic data and delivery room events were recorded using tablet-based applications and synchronised with continuous heart rate data recorded by a dry-electrode electrocardiographic monitor. Heart rate centile curves for the first 3 min of life were generated with piecewise regression analysis. Odds of bradycardia and tachycardia were compared using multiple logistic regression.Results: 1155 crying and 54 non-crying but breathing neonates were included in the final analyses. There were no significant differences in the demographic and obstetric factors between the cohorts. Non-crying but breathing infants had higher rates of early cord clamping <60 s after birth (75.9% vs 46.5%) and admission to the neonatal intensive care unit (13.0% vs 4.3%). There were no significant differences in median heart rates between the cohorts. Non-crying but breathing infants had higher odds of bradycardia (heart rate <100 beats/min, adjusted OR 2.64, 95% CI 1.34 to 5.17) and tachycardia (heart rate = 200 beats/min, adjusted OR 2.86, 95% CI 1.50 to 5.47).Conclusion: Infants who are quietly breathing but do not cry after birth have an increased risk of both bradycardia and tachycardia, and admission to the neonatal intensive care unit.
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