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J Pediatr. 2015 Jan;166(1):49-53. doi: 10.1016/j.jpeds.2014.09.015. Epub 2014 Oct 14.

Pulse oximetry measures a lower heart rate at birth compared with electrocardiography.

Author information

1
Division of Neonatology, Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: J.J.van_Vonderen@lumc.nl.
2
The Ritchie Center, Monash Institute for Medical Research, Monash University, Melbourne, Australia.
3
Division of Neonatology, Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands.
4
Division of Pediatric Cardiology, Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands.
5
Department of Medical Statistics and Bioinformatics, Leiden University Medical Center, Leiden, The Netherlands.

Abstract

OBJECTIVE:

To examine the effect of time after birth on heart rate (HR) measured by pulse oximetry (PO) (HRPO) and electrocardiography (ECG) (HRECG).

STUDY DESIGN:

HRECG and HRPO (collected at maximum sensitivity) were assessed in 53 term and preterm infants at birth. ECG electrodes and a PO sensor were attached as soon as possible and HRECG and HRPO were compared every 30 seconds from 1-10 minutes after birth. Data were compared using a Wilkinson signed-rank test. Clinical relevance (eg, HR <100 beats per minute [bpm] was tested using a McNemar test).

RESULTS:

Seven hundred fifty-five data pairs were analyzed. Median (IQR) gestational age was 37 (31-39) weeks. Mean (SD) starting time of PO and ECG data collection was 99 (33) vs 82 (26) seconds after birth (P = .001). In the first 2 minutes after birth, HRPO was significantly lower compared with HRECG (94 (67-144) vs 150 (91-153) bpm at 60 seconds (P < .05), 81 (60-109) vs 148 (83-170) bpm at 90 seconds (P < .001) and 83 (67-145) vs 158 (119-176) at 120 seconds (P < .001). A HR <100 bpm was more frequently observed with a PO than ECG in the first 2 minutes (64% vs 27% at 60 seconds (P = .05), 56% vs 26% at 90 seconds (P < .05) and 53% vs 21% at 120 seconds (P < .05). HR by ECG was verified by ultrasound for outflow from a subset of infants.

CONCLUSIONS:

In infants at birth, HRPO is significantly lower compared with ECG with clinically important differences in the first minutes.

PMID:
25444526
DOI:
10.1016/j.jpeds.2014.09.015
[Indexed for MEDLINE]

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