TY - JOUR
T1 - The Impact of Maternal and Perinatal Factors on the Neonatal Electrocardiogram
AU - Thygesen, Caroline Boye
AU - Pærregaard, Maria Munk
AU - Molin, Julie
AU - Eskildsen, Lene Friis
AU - Sillesen, Anne-Sophie
AU - Vøgg, Ruth Ottilia Birgitta
AU - Raja, Anna Axelsson
AU - Iversen, Kasper Karmark
AU - Bundgaard, Henning
AU - Christensen, Alex Hørby
N1 - © 2023 S. Karger AG, Basel.
PY - 2024
Y1 - 2024
N2 - INTRODUCTION: Myocardial development is still transitioning by the time of birth making the cardiomyocyte vulnerable to maternal and perinatal factors. We aimed at investigating the impact of maternal and perinatal factors on the neonatal electrocardiogram.METHODS: In a prospective cohort study, neonates underwent cardiac evaluation with electrocardiograms and echocardiograms (age 0-30 days). Associations between medical and demographic data, pregnancy, and birth-related factors, and electrocardiographic parameters were assessed.RESULTS: A total of 15,928 singletons with normal echocardiograms were included (52% boys). Neonates were divided into groups by accumulated number of maternal/perinatal factors: 0, 1, 2, 3, 4, and ≥5, and between-group differences in electrocardiographic parameters were analysed. We observed an additive effect with a leftward shift of the QRS axis and QT prolongation (all p < 0.01). Comparing extreme groups (0 vs. ≥5 maternal/perinatal factors), we found a 4.3% more left-shifted QRS axis (117 vs. 112°, p < 0.001) and a 0.8% prolonged QTcFridericia (QTcF; 363 vs. 366 ms, p < 0.001); the effect on QTcF was most pronounced in neonates examined in the first week of life (360 vs. 368 ms, p < 0.0001).CONCLUSION: We observed a cumulative effect of maternal and perinatal factors on neonatal electrocardiographic parameters, including a more left-shifted QRS axis and increased QT duration, although the variation was within normal reference ranges. Our findings add to the knowledge on the neonatal cardiac transition and the cardiac effect of maternal/perinatal factors.
AB - INTRODUCTION: Myocardial development is still transitioning by the time of birth making the cardiomyocyte vulnerable to maternal and perinatal factors. We aimed at investigating the impact of maternal and perinatal factors on the neonatal electrocardiogram.METHODS: In a prospective cohort study, neonates underwent cardiac evaluation with electrocardiograms and echocardiograms (age 0-30 days). Associations between medical and demographic data, pregnancy, and birth-related factors, and electrocardiographic parameters were assessed.RESULTS: A total of 15,928 singletons with normal echocardiograms were included (52% boys). Neonates were divided into groups by accumulated number of maternal/perinatal factors: 0, 1, 2, 3, 4, and ≥5, and between-group differences in electrocardiographic parameters were analysed. We observed an additive effect with a leftward shift of the QRS axis and QT prolongation (all p < 0.01). Comparing extreme groups (0 vs. ≥5 maternal/perinatal factors), we found a 4.3% more left-shifted QRS axis (117 vs. 112°, p < 0.001) and a 0.8% prolonged QTcFridericia (QTcF; 363 vs. 366 ms, p < 0.001); the effect on QTcF was most pronounced in neonates examined in the first week of life (360 vs. 368 ms, p < 0.0001).CONCLUSION: We observed a cumulative effect of maternal and perinatal factors on neonatal electrocardiographic parameters, including a more left-shifted QRS axis and increased QT duration, although the variation was within normal reference ranges. Our findings add to the knowledge on the neonatal cardiac transition and the cardiac effect of maternal/perinatal factors.
KW - Echocardiography
KW - Electrocardiography
KW - Female
KW - Humans
KW - Infant, Newborn
KW - Male
KW - Pregnancy
KW - Prospective Studies
KW - Neonates
KW - Maternal factors
KW - Cardiac conduction system
KW - Perinatal factors
UR - http://www.scopus.com/inward/record.url?scp=85180351925&partnerID=8YFLogxK
U2 - 10.1159/000534532
DO - 10.1159/000534532
M3 - Journal article
C2 - 38071965
SN - 1661-7800
VL - 121
SP - 167
EP - 177
JO - Neonatology
JF - Neonatology
IS - 2
ER -