Immediate heart rate changes in late preterm infants receiving resuscitation in the delivery room.

OBJECTIVES

Assess heart rate (HR) trends in the minutes following delivery in late preterm infants 34-36 6/7 weeks with spontaneous respirations and compare trends in infants with delayed transition requiring interventions and assess the direct potential impact of these interventions on HR changes.

DESIGN

Prospective observational single center study in 20 late preterm infants born via cesarean section utilizing the NeoBeat which uses dry electrode technology to obtain blinded HR measures in infants with spontaneous respirations versus infants requiring interventions i.e.: positive pressure ventilation, continuous positive airway pressure or suctioning.

RESULTS

Initial HR in spontaneously breathing infants (n = 8) was higher versus those requiring interventions, differences that persisted through five minutes. Iatrogenic bradycardia ranging from 65 to 90 beats/minute was induced by interventions in five(42%) of 12 infants.

CONCLUSIONS

Initial HR in spontaneously breathing late preterm infants was significantly higher compared to infants who received interventions. Respiratory interventions induced sudden unanticipated bradycardia in many cases.