Delivery room desaturations and bradycardia in the early postnatal period of healthy term neonates – a prospective observational study. (18th April 2022)

• Record Type: Journal Article
• Authors: Burgmann, D.-M; Foerster, K.; Klemme, M.; Delius, M.; Hübener, C.; Wisskott, R.; Boulesteix, A. L.; Flemmer, A. W.
• Is Part Of: Journal of maternal-fetal & neonatal medicine. Volume 35:Number 8(2022)
• Page Start: 1457
• Page End: 1461
• Publication Date: 2022-04-18
• Subjects: Postnatal SpO2 -- heart rate -- delivery room ALTE -- term newborn -- bradycardia; Obstetrics -- Periodicals; Perinatology -- Periodicals; Infants (Newborn) -- Diseases -- Periodicals; Neonatology -- Periodicals; 618.2
• DOI: 10.1080/14767058.2020.1757064
• Languages: English
• ISSNs: 1476-7058

Abstract

Abstract: Objective: It has been suggested that desaturations and bradycardia precede acute life-threatening events (ALTE) and that ALTE is more common in the delivery room than later in life. However, frequency, duration and severity of desaturations in the first hours of life and additional risk factors have not readily been studied. Methods: Term neonates ( n = 100) were monitored for the first two hours after birth by pulse oximetry. The impact of maternal and perinatal factors on the frequency and severity of desaturations (<85%) and bradycardia (<80/min) was evaluated. Results: Desaturations were detected in 30%, prolonged desaturations in 25% of infants. Desaturations were observed significantly more often in infants born by planned Cesarean section (pCs) compared to other modes of delivery (pCs 20/49; others 10/51; p = .029). Desaturations were also more frequent in infants diagnosed with neonatal infection (NI) or infants born to a mother with gestational diabetes (GDM), although not significantly. No bradycardia <80/min was detected. Conclusions: In our collective 4% of healthy term neonates had prolonged, clinically relevant desaturations in the first hours after birth. The mode of delivery and maternal risk factors may increase the risk for these events. However, our cohort was too small to detect any ALTE or SIDS and determine potential risk factors for these events. Our data lay ground for a large-scale prospective trial to investigate whether the mode of delivery could be an indication for general pulse oximetry monitoring of newborn in the delivery room.