BMJ open · 2026
Heart rate trends in healthy newborns ≥35+0 weeks' gestation after caesarean delivery with extrauterine placental transfusion and physiology-based cord clamping: a Norwegian observational study (INTACT-3).
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Saether Elisabeth, Andersson Ola, Myklebust Tor Åge, Bernitz Stine, Bjellmo Solveig, Stridsklev Solhild, Eriksen Beate Horsberg
Аннотация
OBJECTIVE: To describe the normal heart rate (HR) of healthy newborns ≥35+0 weeks' gestation in the first 10 min after caesarean delivery (CD) with extrauterine placental transfusion, using dry-electrode ECG (NeoBeat).
DESIGN: Single-centre, prospective observational study.
SETTING: Norwegian County Hospital.
PATIENTS: Newborns ≥35+0 weeks' gestation delivered by CD under regional anaesthesia were eligible for inclusion. Newborns delivered by CD under general anaesthesia, or who needed medical intervention, were excluded.
INTERVENTIONS: NeoBeat was attached to the newborn's chest immediately following delivery. The placenta was delivered without cord clamping after 60-90 s and transferred with the newborn to a resuscitation table. Modified physiology-based cord clamping (PBCC) was performed.
MAIN OUTCOME MEASURES: HR was recorded every second for 10 min. HR quartiles were calculated. Events possibly influencing HR were annotated using Liveborn Observation App.
RESULTS: 89 newborns with a mean (SD) gestational age of 39+3 weeks (10 days) and birth weight of 3649 (536) g were included. Median (IQR) HR was 164 (117-176) and 169 (145-186) beats per minute at 20 s and 30 s, respectively, peaking at 169 (152-183) beats per minute at 4 min and then slowly decreasing to 157 (146-167) beats per minute at 10 min. HR was not significantly affected by intact-cord blood sampling (mean difference=5.4 (95% CI -1.4 to 12.1)), placental delivery (mean difference=0.7 (95% CI -3.5 to 4.9)) or cord clamping (mean difference =-0.6 (95% CI -2.1 to 0.9)).
CONCLUSIONS: This report describes, for the first time, HR quartiles for healthy newborns ≥350 weeks' gestation from 15 s to 20 s and up to 10 min after CD with extrauterine placental transfusion and PBCC.
DESIGN: Single-centre, prospective observational study.
SETTING: Norwegian County Hospital.
PATIENTS: Newborns ≥35+0 weeks' gestation delivered by CD under regional anaesthesia were eligible for inclusion. Newborns delivered by CD under general anaesthesia, or who needed medical intervention, were excluded.
INTERVENTIONS: NeoBeat was attached to the newborn's chest immediately following delivery. The placenta was delivered without cord clamping after 60-90 s and transferred with the newborn to a resuscitation table. Modified physiology-based cord clamping (PBCC) was performed.
MAIN OUTCOME MEASURES: HR was recorded every second for 10 min. HR quartiles were calculated. Events possibly influencing HR were annotated using Liveborn Observation App.
RESULTS: 89 newborns with a mean (SD) gestational age of 39+3 weeks (10 days) and birth weight of 3649 (536) g were included. Median (IQR) HR was 164 (117-176) and 169 (145-186) beats per minute at 20 s and 30 s, respectively, peaking at 169 (152-183) beats per minute at 4 min and then slowly decreasing to 157 (146-167) beats per minute at 10 min. HR was not significantly affected by intact-cord blood sampling (mean difference=5.4 (95% CI -1.4 to 12.1)), placental delivery (mean difference=0.7 (95% CI -3.5 to 4.9)) or cord clamping (mean difference =-0.6 (95% CI -2.1 to 0.9)).
CONCLUSIONS: This report describes, for the first time, HR quartiles for healthy newborns ≥350 weeks' gestation from 15 s to 20 s and up to 10 min after CD with extrauterine placental transfusion and PBCC.