Observational study comparing heart rate in crying and non-crying but breathing infants at birth
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 infan...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-04-01
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| Series: | BMJ Paediatrics Open |
| Online Access: | https://bmjpaedsopen.bmj.com/content/7/1/e001886.full |
| _version_ | 1797213595257274368 |
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| author | Ashish KC Joar Eilevstjønn Antti Juhani Kukka Omkar Basnet Sara K Berkelhamer Thomas Ragnar Wood |
| author_facet | Ashish KC Joar Eilevstjønn Antti Juhani Kukka Omkar Basnet Sara K Berkelhamer Thomas Ragnar Wood |
| author_sort | Ashish KC |
| collection | DOAJ |
| description | 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.Trial registration number ISRCTN18148368. |
| first_indexed | 2024-03-08T17:25:39Z |
| format | Article |
| id | doaj.art-6cd28ceb1d874550b7ca46cd4b464fcf |
| institution | Directory Open Access Journal |
| issn | 2399-9772 |
| language | English |
| last_indexed | 2024-04-24T11:00:46Z |
| publishDate | 2023-04-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Paediatrics Open |
| spelling | doaj.art-6cd28ceb1d874550b7ca46cd4b464fcf2024-04-11T19:00:09ZengBMJ Publishing GroupBMJ Paediatrics Open2399-97722023-04-017110.1136/bmjpo-2023-001886Observational study comparing heart rate in crying and non-crying but breathing infants at birthAshish KC0Joar Eilevstjønn1Antti Juhani Kukka2Omkar Basnet3Sara K Berkelhamer4Thomas Ragnar Wood5Department of Women’s and Children’s Health, Uppsala University, Uppsala, SwedenStrategic Research, Laerdal Global Health, Stavanger, Rogaland, NorwayDepartment of Women’s and Children’s Health, Uppsala University, Uppsala, SwedenGolden Community, Lalitpur, NepalDivision of Neonatology, Department of Pediatrics, University of Washington, Seattle, Washington, USADivision of Neonatology, Department of Pediatrics, University of Washington, Seattle, Washington, USABackground 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.Trial registration number ISRCTN18148368.https://bmjpaedsopen.bmj.com/content/7/1/e001886.full |
| spellingShingle | Ashish KC Joar Eilevstjønn Antti Juhani Kukka Omkar Basnet Sara K Berkelhamer Thomas Ragnar Wood Observational study comparing heart rate in crying and non-crying but breathing infants at birth BMJ Paediatrics Open |
| title | Observational study comparing heart rate in crying and non-crying but breathing infants at birth |
| title_full | Observational study comparing heart rate in crying and non-crying but breathing infants at birth |
| title_fullStr | Observational study comparing heart rate in crying and non-crying but breathing infants at birth |
| title_full_unstemmed | Observational study comparing heart rate in crying and non-crying but breathing infants at birth |
| title_short | Observational study comparing heart rate in crying and non-crying but breathing infants at birth |
| title_sort | observational study comparing heart rate in crying and non crying but breathing infants at birth |
| url | https://bmjpaedsopen.bmj.com/content/7/1/e001886.full |
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