Increased risk of bradycardia in vigorous infants receiving early as compared to delayed cord clamping at birth

OBJECTIVE: To compare HR pattern of vigorous newborns during the first 180 s with early (≤60 s, ECC) or delayed (>60 s, DCC) cord clamping. STUDY DESIGN: Observational study including dry-electrode ECG monitoring of 610 vaginally-born singleton term and late-preterm (≥34 weeks) who were vigorous...

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Autores principales: KC, Ashish, Kong, So Yeon Joyce, Haaland, Solveig Haukås, Eilevstjønn, Joar, Myklebust, Helge, Bastola, Ram Chandra, Wood, Thomas Ragnar, Niermeyer, Susan, Berkelhamer, Sara
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group US 2022
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Article
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10256607/
https://www.ncbi.nlm.nih.gov/pubmed/36587054
http://dx.doi.org/10.1038/s41372-022-01593-1
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author KC, Ashish
Kong, So Yeon Joyce
Haaland, Solveig Haukås
Eilevstjønn, Joar
Myklebust, Helge
Bastola, Ram Chandra
Wood, Thomas Ragnar
Niermeyer, Susan
Berkelhamer, Sara
author_facet KC, Ashish
Kong, So Yeon Joyce
Haaland, Solveig Haukås
Eilevstjønn, Joar
Myklebust, Helge
Bastola, Ram Chandra
Wood, Thomas Ragnar
Niermeyer, Susan
Berkelhamer, Sara
author_sort KC, Ashish
collection PubMed
description OBJECTIVE: To compare HR pattern of vigorous newborns during the first 180 s with early (≤60 s, ECC) or delayed (>60 s, DCC) cord clamping. STUDY DESIGN: Observational study including dry-electrode ECG monitoring of 610 vaginally-born singleton term and late-preterm (≥34 weeks) who were vigorous after birth. RESULTS: 198 received ECC while 412 received DCC with median cord clamping at 37 s and 94 s. Median HR remained stable from 30 to 180 s with DCC (172 and 170 bpm respectively) but increased with ECC (169 and 184 bpm). The proportion with bradycardia was higher among ECC than DCC at 30 s and fell faster in the DCC through 60 s. After adjusting for factors affecting timing of cord clamping, ECC had significant risk of bradycardia compared to DCC (aRR 1.51; 95% CI; 1.01–2.26). CONCLUSION: Early heart instability and higher risk of bradycardia with ECC as compared to DCC supports the recommended clinical practice of DCC.
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spelling pubmed-102566072023-06-11 Increased risk of bradycardia in vigorous infants receiving early as compared to delayed cord clamping at birth KC, Ashish Kong, So Yeon Joyce Haaland, Solveig Haukås Eilevstjønn, Joar Myklebust, Helge Bastola, Ram Chandra Wood, Thomas Ragnar Niermeyer, Susan Berkelhamer, Sara J Perinatol Article OBJECTIVE: To compare HR pattern of vigorous newborns during the first 180 s with early (≤60 s, ECC) or delayed (>60 s, DCC) cord clamping. STUDY DESIGN: Observational study including dry-electrode ECG monitoring of 610 vaginally-born singleton term and late-preterm (≥34 weeks) who were vigorous after birth. RESULTS: 198 received ECC while 412 received DCC with median cord clamping at 37 s and 94 s. Median HR remained stable from 30 to 180 s with DCC (172 and 170 bpm respectively) but increased with ECC (169 and 184 bpm). The proportion with bradycardia was higher among ECC than DCC at 30 s and fell faster in the DCC through 60 s. After adjusting for factors affecting timing of cord clamping, ECC had significant risk of bradycardia compared to DCC (aRR 1.51; 95% CI; 1.01–2.26). CONCLUSION: Early heart instability and higher risk of bradycardia with ECC as compared to DCC supports the recommended clinical practice of DCC. Nature Publishing Group US 2022-12-31 2023 /pmc/articles/PMC10256607/ /pubmed/36587054 http://dx.doi.org/10.1038/s41372-022-01593-1 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
KC, Ashish
Kong, So Yeon Joyce
Haaland, Solveig Haukås
Eilevstjønn, Joar
Myklebust, Helge
Bastola, Ram Chandra
Wood, Thomas Ragnar
Niermeyer, Susan
Berkelhamer, Sara
Increased risk of bradycardia in vigorous infants receiving early as compared to delayed cord clamping at birth
title Increased risk of bradycardia in vigorous infants receiving early as compared to delayed cord clamping at birth
title_full Increased risk of bradycardia in vigorous infants receiving early as compared to delayed cord clamping at birth
title_fullStr Increased risk of bradycardia in vigorous infants receiving early as compared to delayed cord clamping at birth
title_full_unstemmed Increased risk of bradycardia in vigorous infants receiving early as compared to delayed cord clamping at birth
title_short Increased risk of bradycardia in vigorous infants receiving early as compared to delayed cord clamping at birth
title_sort increased risk of bradycardia in vigorous infants receiving early as compared to delayed cord clamping at birth
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10256607/
https://www.ncbi.nlm.nih.gov/pubmed/36587054
http://dx.doi.org/10.1038/s41372-022-01593-1
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