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Article

Delivery Room ST Segment Analysis to Predict Short Term Outcomes in Near-Term and Term Newborns

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Department of Obstetrics and Gynecology, Stavanger University Hospital, 4068 Stavanger, Norway
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Department of Pediatric and Adolescent Medicine, Oslo University Hospital, 0424 Oslo, Norway
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Laerdal Medical and Laerdal Global Health, 4002 Stavanger, Norway
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Haydom Lutheran Hospital, Private Bag Mbulu, Haydom P.O. Box 9000, Tanzania
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Medical College, Agakhan University, Dar es Salaam P.O. Box 38129, Tanzania
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Faculty of Health Sciences, University of Stavanger, P.O. Box 8600, 4036 Stavanger, Norway
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Critical Care and Anaesthesiology Research Group, Stavanger University Hospital, 4068 Stavanger, Norway
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Pediatric Research Group, Faculty of Health Sciences, UiT—The Arctic University of Norway, 9019 Tromsø, Norway
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Department of Pediatrics and Adolescent Medicine, University Hospital North Norway, 9019 Tromsø, Norway
*
Author to whom correspondence should be addressed.
Academic Editor: Ivan Hand
Children 2022, 9(1), 54; https://doi.org/10.3390/children9010054
Received: 25 November 2021 / Revised: 16 December 2021 / Accepted: 23 December 2021 / Published: 3 January 2022
(This article belongs to the Special Issue Newborn Resuscitation: Advances in Training and Practice)
Background: ST-segment changes to the fetal electrocardiogram (ECG) may indicate fetal acidosis. No large-scale characterization of ECG morphology immediately after birth has been performed, but ECG is used for heart rate (HR) assessment. We aimed to investigate ECG morphology immediately after birth in asphyxiated infants, using one-lead dry-electrode ECG developed for HR measurement. Methods: Observational study in Tanzania, between 2013–2018. Near-term and term infants that received bag-mask ventilation (BMV), and healthy controls, were monitored with one-lead dry-electrode ECG with a non-diagnostic bandwidth. ECGs were classified as normal, with ST-elevations or other ST-segment abnormalities including a biphasic ST-segment. We analyzed ECG morphology in relation to perinatal variables or short-term outcomes. Results: A total of 494 resuscitated and 25 healthy infants were included. ST-elevations were commonly seen both in healthy infants (7/25; 28%) and resuscitated (320/494; 65%) infants. The apparent ST-elevations were not associated with perinatal variables or short-term outcomes. Among the 32 (6.4%) resuscitated infants with “other ST-segment abnormalities”, duration of BMV was longer, 1-min Apgar score lower and normal outcomes less frequent than in the resuscitated infants with normal ECG or ST-elevations. Conclusions: ST-segment elevation was commonly seen and not associated with negative outcomes when using one-lead dry-electrode ECG. Other ST-segment abnormalities were associated with prolonged BMV and worse outcome. ECG with appropriate bandwidth and automated analysis may potentially in the future aid in the identification of severely asphyxiated infants. View Full-Text
Keywords: Electrocardiography; bag-mask ventilation; perinatal asphyxia; ST-elevation Electrocardiography; bag-mask ventilation; perinatal asphyxia; ST-elevation
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MDPI and ACS Style

Linde, J.; Solevåg, A.L.; Eilevstjønn, J.; Blacy, L.; Kidanto, H.; Ersdal, H.; Klingenberg, C. Delivery Room ST Segment Analysis to Predict Short Term Outcomes in Near-Term and Term Newborns. Children 2022, 9, 54. https://doi.org/10.3390/children9010054

AMA Style

Linde J, Solevåg AL, Eilevstjønn J, Blacy L, Kidanto H, Ersdal H, Klingenberg C. Delivery Room ST Segment Analysis to Predict Short Term Outcomes in Near-Term and Term Newborns. Children. 2022; 9(1):54. https://doi.org/10.3390/children9010054

Chicago/Turabian Style

Linde, Jørgen, Anne L. Solevåg, Joar Eilevstjønn, Ladislaus Blacy, Hussein Kidanto, Hege Ersdal, and Claus Klingenberg. 2022. "Delivery Room ST Segment Analysis to Predict Short Term Outcomes in Near-Term and Term Newborns" Children 9, no. 1: 54. https://doi.org/10.3390/children9010054

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