Heart rate trends in healthy newborns ≥35+0 weeks’ gestation after caesarean delivery with extrauterine placental transfusion and physiology-based cord clamping : a Norwegian observational study (INTACT-3)

Saether, Elisabeth; Andersson, Ola; Myklebust, Tor Åge; Bernitz, Stine; Bjellmo, Solveig; Stridsklev, Solhild; Eriksen, Beate Horsberg

Heart rate trends in healthy newborns ≥35+0 weeks’ gestation after caesarean delivery with extrauterine placental transfusion and physiology-based cord clamping : a Norwegian observational study (INTACT-3)

Mark

; Myklebust, Tor Åge ; Bernitz, Stine ; Bjellmo, Solveig ; Stridsklev, Solhild and Eriksen, Beate Horsberg (2026) In BMJ Open 16(4). p.1-8

Abstract: Objective: To describe the normal heart rate (HR) of healthy newborns ≥35+0 weeks’ gestation in the first 10 min after caesarean delivery (CD) with extrauterine placental transfusion, using dry-electrode ECG (NeoBeat). Design: Single-centre, prospective observational study. Setting: Norwegian County Hospital. Patients: Newborns ≥35+0 weeks’ gestation delivered by CD under regional anaesthesia were eligible for inclusion. Newborns delivered by CD under general anaesthesia, or who needed medical intervention, were excluded. Interventions: NeoBeat was attached to the newborn’s chest immediately following delivery. The placenta was delivered without cord clamping after 60–90 s and transferred with the newborn to a resuscitation table.... (More); Objective: To describe the normal heart rate (HR) of healthy newborns ≥35+0 weeks’ gestation in the first 10 min after caesarean delivery (CD) with extrauterine placental transfusion, using dry-electrode ECG (NeoBeat). Design: Single-centre, prospective observational study. Setting: Norwegian County Hospital. Patients: Newborns ≥35+0 weeks’ gestation delivered by CD under regional anaesthesia were eligible for inclusion. Newborns delivered by CD under general anaesthesia, or who needed medical intervention, were excluded. Interventions: NeoBeat was attached to the newborn’s chest immediately following delivery. The placenta was delivered without cord clamping after 60–90 s and transferred with the newborn to a resuscitation table. Modified physiology-based cord clamping (PBCC) was performed. Main outcome measures: HR was recorded every second for 10 min. HR quartiles were calculated. Events possibly influencing HR were annotated using Liveborn Observation App. Results: 89 newborns with a mean (SD) gestational age of 39+3 weeks (10 days) and birth weight of 3649 (536) g were included. Median (IQR) HR was 164 (117–176) and 169 (145–186) beats per minute at 20 s and 30 s, respectively, peaking at 169 (152–183) beats per minute at 4 min and then slowly decreasing to 157 (146–167) beats per minute at 10 min. HR was not significantly affected by intact-cord blood sampling (mean difference=5.4 (95% CI −1.4 to 12.1)), placental delivery (mean difference=0.7 (95% CI −3.5 to 4.9)) or cord clamping (mean difference =−0.6 (95% CI −2.1 to 0.9)). Conclusions: This report describes, for the first time, HR quartiles for healthy newborns ≥35⁰ weeks’ gestation from 15 s to 20 s and up to 10 min after CD with extrauterine placental transfusion and PBCC.
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Please use this url to cite or link to this publication: https://lup.lub.lu.se/record/18ec621a-f6f1-4b40-a44e-4d7c007f086e

author

Saether, Elisabeth ; Andersson, Ola ^LU

; Myklebust, Tor Åge ; Bernitz, Stine ; Bjellmo, Solveig ; Stridsklev, Solhild and Eriksen, Beate Horsberg

organization

Neonatology (research group)

publishing date

2026-04

type

Contribution to journal

publication status

published

subject

keywords

Midwifery, NEONATOLOGY, OBSTETRICS

in

BMJ Open

volume

16

issue

4

article number

e104121

pages

1 - 8

publisher

BMJ Publishing Group

external identifiers

scopus:105036254951
pmid:42009392

ISSN

2044-6055

DOI

10.1136/bmjopen-2025-104121

language

English

LU publication?

yes

additional info

Publisher Copyright: © Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: https://creativecommons.org/licenses/by-nc/4.0/.

id

18ec621a-f6f1-4b40-a44e-4d7c007f086e

date added to LUP

2026-06-04 23:03:56

date last changed

2026-06-05 09:52:03

@article{18ec621a-f6f1-4b40-a44e-4d7c007f086e,
  abstract     = {{<p>Objective: To describe the normal heart rate (HR) of healthy newborns ≥35+0 weeks’ gestation in the first 10 min after caesarean delivery (CD) with extrauterine placental transfusion, using dry-electrode ECG (NeoBeat). Design: Single-centre, prospective observational study. Setting: Norwegian County Hospital. Patients: Newborns ≥35+0 weeks’ gestation delivered by CD under regional anaesthesia were eligible for inclusion. Newborns delivered by CD under general anaesthesia, or who needed medical intervention, were excluded. Interventions: NeoBeat was attached to the newborn’s chest immediately following delivery. The placenta was delivered without cord clamping after 60–90 s and transferred with the newborn to a resuscitation table. Modified physiology-based cord clamping (PBCC) was performed. Main outcome measures: HR was recorded every second for 10 min. HR quartiles were calculated. Events possibly influencing HR were annotated using Liveborn Observation App. Results: 89 newborns with a mean (SD) gestational age of 39+3 weeks (10 days) and birth weight of 3649 (536) g were included. Median (IQR) HR was 164 (117–176) and 169 (145–186) beats per minute at 20 s and 30 s, respectively, peaking at 169 (152–183) beats per minute at 4 min and then slowly decreasing to 157 (146–167) beats per minute at 10 min. HR was not significantly affected by intact-cord blood sampling (mean difference=5.4 (95% CI −1.4 to 12.1)), placental delivery (mean difference=0.7 (95% CI −3.5 to 4.9)) or cord clamping (mean difference =−0.6 (95% CI −2.1 to 0.9)). Conclusions: This report describes, for the first time, HR quartiles for healthy newborns ≥35<sup>0</sup> weeks’ gestation from 15 s to 20 s and up to 10 min after CD with extrauterine placental transfusion and PBCC.</p>}},
  author       = {{Saether, Elisabeth and Andersson, Ola and Myklebust, Tor Åge and Bernitz, Stine and Bjellmo, Solveig and Stridsklev, Solhild and Eriksen, Beate Horsberg}},
  issn         = {{2044-6055}},
  keywords     = {{Midwifery; NEONATOLOGY; OBSTETRICS}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{1--8}},
  publisher    = {{BMJ Publishing Group}},
  series       = {{BMJ Open}},
  title        = {{Heart rate trends in healthy newborns ≥35+0 weeks’ gestation after caesarean delivery with extrauterine placental transfusion and physiology-based cord clamping : a Norwegian observational study (INTACT-3)}},
  url          = {{http://dx.doi.org/10.1136/bmjopen-2025-104121}},
  doi          = {{10.1136/bmjopen-2025-104121}},
  volume       = {{16}},
  year         = {{2026}},
}

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Heart rate trends in healthy newborns ≥35+0 weeks’ gestation after caesarean delivery with extrauterine placental transfusion and physiology-based cord clamping : a Norwegian observational study (INTACT-3)