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Review
. 2024 Jun 5:19:100668.
doi: 10.1016/j.resplu.2024.100668. eCollection 2024 Sep.

Fast and accurate newborn heart rate monitoring at birth: A systematic review

Vishal S Kapadia  1 , Mandira D Kawakami  2 , Marya L Strand  3 , Cameron Paul Hurst  4 , Angela Spencer  5 , Georg M Schmölzer  6 , Yacov Rabi  7 , Jonathan Wyllie  8 , Gary Weiner  9 , Helen G Liley  10 , Myra H Wyckoff  1 ; International Liaison Committee on Resuscitation Neonatal Life Support Task Force
Affiliations
Review

Fast and accurate newborn heart rate monitoring at birth: A systematic review

Vishal S Kapadia et al. Resusc Plus. .

Abstract

Aim: To examine speed and accuracy of newborn heart rate measurement by various assessment methods employed at birth.

Methods: A search of Medline, SCOPUS, CINAHL and Cochrane was conducted between January 1, 1946, to until August 16, 2023. (CRD 42021283364) Study selection was based on predetermined criteria. Reviewers independently extracted data, appraised risk of bias and assessed certainty of evidence.

Results: Pulse oximetry is slower and less precise than ECG for heart rate assessment. Both auscultation and palpation are imprecise for heart rate assessment. Other devices such as digital stethoscope, Doppler ultrasound, an ECG device using dry electrodes incorporated in a belt, photoplethysmography and electromyography are studied in small numbers of newborns and data are not available for extremely preterm or bradycardic newborns receiving resuscitation. Digital stethoscope is fast and accurate. Doppler ultrasound and dry electrode ECG in a belt are fast, accurate and precise when compared to conventional ECG with gel adhesive electrodes.

Limitations: Certainty of evidence was low or very low for most comparisons.

Conclusion: If resources permit, ECG should be used for fast and accurate heart rate assessment at birth. Pulse oximetry and auscultation may be reasonable alternatives but have limitations. Digital stethoscope, doppler ultrasound and dry electrode ECG show promise but need further study.

Keywords: Auscultation; Bradycardia; Digital stethoscope; Doppler ultrasound; Dry electrode ECG; Electrocardiogram; Heart Rate; ILCOR; Meta-analysis; NRP; Newborn; Palpation; Pulse oximeter; Resuscitation; Systematic review.

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Conflict of interest statement

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: ‘Dr. Kapadia is a co-author of one of the studies included in this review. Drs. Liley and Rabi are editorial board members for the Resuscitation Plus journal. The other authors have no conflicts to disclose.’.

Figures

Fig. 1
Fig. 1
PRISMA study selection diagram.
Fig. 2
Fig. 2
PO vs ECG time to HR from device placement. (a) Randomized control trials. (b) Observational studies.
Fig. 2
Fig. 2
PO vs ECG time to HR from device placement. (a) Randomized control trials. (b) Observational studies.
Fig. 3
Fig. 3
PO vs ECG Time for first HR from birth. (a) Randomized controlled trials. (b) Observational studies.
Fig. 3
Fig. 3
PO vs ECG Time for first HR from birth. (a) Randomized controlled trials. (b) Observational studies.
Fig. 4
Fig. 4
Auscultation vs ECG. (a) Time to first HR from device placement (Observational studies). (b) Time to first HR from birth (Observational studies).
Fig. 4
Fig. 4
Auscultation vs ECG. (a) Time to first HR from device placement (Observational studies). (b) Time to first HR from birth (Observational studies).
See this image and copyright information in PMC

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