The Impact of Maternal and Perinatal Factors on the Neonatal Electrocardiogram

Caroline Boye Thygesen, Maria Munk Pærregaard, Julie Molin, Lene Friis Eskildsen, Anne-Sophie Sillesen, Ruth Ottilia Birgitta Vøgg, Anna Axelsson Raja, Kasper Karmark Iversen, Henning Bundgaard, Alex Hørby Christensen*

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

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.

Original languageEnglish
JournalNeonatology
Volume121
Issue number2
Pages (from-to)167-177
Number of pages11
ISSN1661-7800
DOIs
Publication statusPublished - 2024

Bibliographical note

Publisher Copyright:
© 2023 S. Karger AG, Basel. Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.

Keywords

  • Cardiac conduction system
  • Electrocardiography
  • Maternal factors
  • Neonates
  • Perinatal factors

Cite this