Mode of Delivery and Neonatal Transition: Insights from Electrical Cardiometry

TL;DR

This study uses Electrical Cardiometry to show that heart function declines in the first hour after birth, with vaginally delivered infants showing better initial cardiovascular performance than those born via Cesarean section.

Contribution

The study introduces Electrical Cardiometry as a noninvasive method to measure neonatal hemodynamics during the critical first hour of life.

Findings

Heart rate, stroke volume index, cardiac output index, and contractility all decreased significantly in the first hour after birth.

Vaginally delivered infants had higher heart rate, stroke volume index, cardiac output index, and contractility compared to Cesarean section infants.

The decline in hemodynamic variables was consistent across both full-term and preterm infants.

Abstract

Background/Objectives: Examining hemodynamic changes during the early transition period aids in identifying variations in neonatal outcomes linked to ante- or intrapartum events. It facilitates the recognition of potential impacts stemming from common intrapartum management practices. The current literature provides scant insights into cardio-circulatory changes during the crucial first 10 min after birth. The application of Electrical Cardiometry (EC) emerges as a valuable noninvasive clinical tool for measuring neonatal hemodynamics. This prospective cohort study aimed to assess hemodynamic variables, including heart rate (HR), stroke volume index (SVI), index of contractility (ICON), and cardiac output index (COI) during the first hour of life in late preterm and full-term infants. Additionally, this study investigated the relationship between the mode of delivery and cardiovascular adaptation. Methods: Two hundred infants, encompassing both full-term and preterm, were enrolled, with categorization into four groups based on mode of delivery and gestational age. Hemodynamic variables were continuously evaluated using an EC device throughout the first hour of life. Findings: A significant decreasing trend was observed in HR, SVI, COI, and ICON over the first hour of life (p < 0.001). Infants delivered vaginally exhibited significantly higher HR, COI, SVI, and ICON compared to those born via Cesarean section (CS) (p = 0.006 and <0.001 and 0.035 and 0.001, respectively). Conclusions: This study highlights a consistent decreasing trend in HR, SVI, COI, and ICON over the first hour of life in both full-term and preterm infants. Notably, hemodynamic variables exhibited heightened levels in infants delivered vaginally compared to those born by CS.

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