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The evolution of the neonatal QRS axis during the first four weeks of life

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@article{8a5b1dbb5e1f4cdfa985d1c7ee7c3174,
title = "The evolution of the neonatal QRS axis during the first four weeks of life",
abstract = "Background: The QRS axis represents the sum and orientation of the ventricular depolarization. Accurate interpretation of abnormalities in the QRS axis may facilitate early diagnosis of heart disease in newborns. We aimed at describing the evolution of the QRS axis during the first 4 weeks of life and provide reference values from healthy newborns. Methods: The Copenhagen Baby Heart Study is a prospective general population study that offered cardiac evaluation during the first month of life to all newborns delivered in the Copenhagen area. Results: Electrocardiograms from 12,317 newborns (52% boys; mean age 12 days) with normal echocardiograms were included. The median QRS axis was 119° at the ages 0-7 days and shifted leftward to 102° at the ages 22-28 days (p < 0.001). We found that girls had a significantly less pronounced right-shifted axis than boys (p < 0.001) and that increasing gestational age (GA) was associated with a more pronounced right-shifted axis (p < 0.05). Infant size did not affect the axis (p > 0.05). Only 0.5% had an axis within the interval 0 to −90° and 1.1% in the interval +240 to +30°. Conclusions: The QRS axis showed a gradual leftward-shift during the first 4 weeks of life and was affected by sex and GA but unaffected by infant size. Less than 1% of the newborns had a QRS axis between 0 and −90°. This study represents updated reference values, which may facilitate the clinical handling of newborns.",
keywords = "Electrocardiography, Newborns, QRS axis, Reference values",
author = "P{\ae}rregaard, {Maria Munk} and Jesper Kock and Christian Pihl and Adrian Pietersen and Iversen, {Kasper Karmark} and Henning Bundgaard and Christensen, {Alex H{\o}rby}",
note = "Publisher Copyright: {\textcopyright} 2021 S. Karger AG, Basel Copyright: Copyright 2021 Elsevier B.V., All rights reserved.",
year = "2021",
month = jun,
doi = "10.1159/000513526",
language = "English",
volume = "118",
pages = "155--162",
journal = "Neonatology",
issn = "1661-7800",
publisher = "S./Karger AG",
number = "2",

}

RIS

TY - JOUR

T1 - The evolution of the neonatal QRS axis during the first four weeks of life

AU - Pærregaard, Maria Munk

AU - Kock, Jesper

AU - Pihl, Christian

AU - Pietersen, Adrian

AU - Iversen, Kasper Karmark

AU - Bundgaard, Henning

AU - Christensen, Alex Hørby

N1 - Publisher Copyright: © 2021 S. Karger AG, Basel Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

PY - 2021/6

Y1 - 2021/6

N2 - Background: The QRS axis represents the sum and orientation of the ventricular depolarization. Accurate interpretation of abnormalities in the QRS axis may facilitate early diagnosis of heart disease in newborns. We aimed at describing the evolution of the QRS axis during the first 4 weeks of life and provide reference values from healthy newborns. Methods: The Copenhagen Baby Heart Study is a prospective general population study that offered cardiac evaluation during the first month of life to all newborns delivered in the Copenhagen area. Results: Electrocardiograms from 12,317 newborns (52% boys; mean age 12 days) with normal echocardiograms were included. The median QRS axis was 119° at the ages 0-7 days and shifted leftward to 102° at the ages 22-28 days (p < 0.001). We found that girls had a significantly less pronounced right-shifted axis than boys (p < 0.001) and that increasing gestational age (GA) was associated with a more pronounced right-shifted axis (p < 0.05). Infant size did not affect the axis (p > 0.05). Only 0.5% had an axis within the interval 0 to −90° and 1.1% in the interval +240 to +30°. Conclusions: The QRS axis showed a gradual leftward-shift during the first 4 weeks of life and was affected by sex and GA but unaffected by infant size. Less than 1% of the newborns had a QRS axis between 0 and −90°. This study represents updated reference values, which may facilitate the clinical handling of newborns.

AB - Background: The QRS axis represents the sum and orientation of the ventricular depolarization. Accurate interpretation of abnormalities in the QRS axis may facilitate early diagnosis of heart disease in newborns. We aimed at describing the evolution of the QRS axis during the first 4 weeks of life and provide reference values from healthy newborns. Methods: The Copenhagen Baby Heart Study is a prospective general population study that offered cardiac evaluation during the first month of life to all newborns delivered in the Copenhagen area. Results: Electrocardiograms from 12,317 newborns (52% boys; mean age 12 days) with normal echocardiograms were included. The median QRS axis was 119° at the ages 0-7 days and shifted leftward to 102° at the ages 22-28 days (p < 0.001). We found that girls had a significantly less pronounced right-shifted axis than boys (p < 0.001) and that increasing gestational age (GA) was associated with a more pronounced right-shifted axis (p < 0.05). Infant size did not affect the axis (p > 0.05). Only 0.5% had an axis within the interval 0 to −90° and 1.1% in the interval +240 to +30°. Conclusions: The QRS axis showed a gradual leftward-shift during the first 4 weeks of life and was affected by sex and GA but unaffected by infant size. Less than 1% of the newborns had a QRS axis between 0 and −90°. This study represents updated reference values, which may facilitate the clinical handling of newborns.

KW - Electrocardiography

KW - Newborns

KW - QRS axis

KW - Reference values

UR - http://www.scopus.com/inward/record.url?scp=85102646035&partnerID=8YFLogxK

U2 - 10.1159/000513526

DO - 10.1159/000513526

M3 - Journal article

C2 - 33691309

AN - SCOPUS:85102646035

VL - 118

SP - 155

EP - 162

JO - Neonatology

JF - Neonatology

SN - 1661-7800

IS - 2

ER -

ID: 66110188