- Introduction of ECG monitoring in the delivery room is associated with fewer endotracheal intubations, higher 5-minute Apgars, and other benefits.
- However, use of chest compressions increased, and mortality remained unchanged.
Why this matters
- The 2017 American Academy of Pediatrics neonatal resuscitation guidelines suggest ECG monitoring in the delivery room, and this unit evaluated outcomes before and after this implementation.
- Compared with infants before ECG monitoring was introduced, those with monitoring had:
- Lower endotracheal intubation rate: 35.5% vs 47.5%; aOR, 0.65 (P=.023);
- Higher 5-minute Apgars: 7 vs 6 (P=.016);
- Reduction in severe retinopathy of prematurity: aOR, 0.32 (P=.005); and
- Increased odds of chest compressions: aOR, 3.59 (P=.009).
- Mortality did not differ between before and after ECG introduction: 8.4% vs 8.8%; aOR, 1.58 (P=.167).
- ECG was done in 369 infants after it was introduced in 2017; the retrospective cohort of 263 infants received no monitoring (born 2015); all infants received positive pressure ventilation.
- Funding: University of Oklahoma.
- Not randomized.
- Unrecognized confounding possible.