Department of Pediatrics, Tampere University Hospital, PO BOX 2000, FI-33521, Tampere, Finland.
Tampere Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
Eur J Pediatr. 2023 May;182(5):2359-2367. doi: 10.1007/s00431-023-04914-4. Epub 2023 Mar 8.
To evaluate heart rate (HR), the presence of extrasystoles and other Holter findings among healthy newborns, and to collect data for new normal limits for Holter parameters in newborns. For this cross-sectional study, 70 healthy term newborns were recruited to undergo 24-h Holter monitoring. Linear regression analysis was used in HR analyses. The age-specific limits for HRs were calculated using linear regression analysis coefficients and residuals. The mean (SD) age of the infants was 6.4 (1.7) days during the recording. Each consecutive day of age raised the minimum and mean HR by 3.8 beats per minute (bpm) (95% CI: 2.4, 5.2; P < .001) and 4.0 bpm (95% CI: 2.8, 5.2; P < .001), respectively. Age did not correlate with maximum HR. The lowest calculated limit for minimum HR ranged from 56 bpm (aged 3 days) to 78 bpm (aged 9 days). A small number of atrial extrasystoles and ventricular extrasystoles were observed in 54 (77%) and 28 (40%) recordings, respectively. Short supraventricular or ventricular tachycardias were found in 6 newborns (9%).
The present study shows an increase of 20 bpm in both the minimum and mean HRs of healthy term newborns between the 3rd and 9th days of life. Daily reference values for HR could be adopted in the interpretation of HR monitoring results in newborns. A small number of extrasystoles are common in healthy newborns, and isolated short tachycardias may be normal in this age group.
• The current definition of bradycardia in newborns is 80 beats per minute. • This definition does not fit into the modern clinical setting of continuously monitored newborns, where benign bradycardias are commonly observed.
• A linear and clinically significant increase in heart rate was observed in infants between the ages of 3 and 9 days. • It appears as though lower normal limits for heart rate could be applied to the youngest newborns.
评估健康新生儿的心率（HR）、室性期前收缩和动态心电图的其他发现，并为新生儿动态心电图参数的新正常范围收集数据。
本横断面研究纳入了 70 例健康足月新生儿进行 24 小时动态心电图监测。采用线性回归分析进行 HR 分析。通过线性回归分析系数和残差计算 HR 的年龄特异性界限。
记录时婴儿的平均（SD）年龄为 6.4（1.7）天。年龄每增加 1 天，最小和平均 HR 分别增加 3.8 次/分钟（bpm）（95%CI：2.4，5.2；P<0.001）和 4.0 bpm（95%CI：2.8，5.2；P<0.001）。年龄与最大 HR 不相关。最小 HR 的最低计算下限范围为 56 bpm（3 天龄）至 78 bpm（9 天龄）。54 例（77%）和 28 例（40%）记录中分别观察到少量房性期前收缩和室性期前收缩。6 例新生儿（9%）发现短阵室上性或室性心动过速。
本研究显示，健康足月新生儿在生命的第 3 至 9 天之间，最小和平均 HR 分别增加 20 bpm。HR 监测结果的解释中可采用每日 HR 参考值。健康新生儿常见少量期前收缩，该年龄段孤立性短阵心动过速可能正常。
• 目前新生儿心动过缓的定义为 80 次/分钟。• 这个定义与连续监测新生儿的现代临床环境不符，在这种环境中，良性心动过缓很常见。
• 在 3 至 9 天龄的婴儿中观察到心率呈线性且具有临床意义的增加。• 似乎可以将较低的正常心率下限应用于最小的新生儿。
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