Jornal de Pediatria · Published 2026-02-08 · DOI 10.1016/j.jped.2026.101504
Objective: To determine whether the use of an electrocardiogram monitor in newborns receiving positive pressure ventilation (PPV) at birth affects the frequency of tracheal intubation in the delivery room. Methods: Retrospective cohort of liveborn infants without congenital anomalies, with gestational age (GA) ≥ 23 weeks and birth weight ≥ 400 g who received PPV at birth, from 2014 to 2022. Newborns were stratified by GA (< 34 or ≥ 34 weeks) and by use or non-use of an electrocardiogram monitor during resuscitation. Logistic regression was used to assess the association between electrocardiogram monitoring and outcomes of interest for each GA group. Results: Among 5622 live births, 516 met the inclusion criteria; 224 (43 %) were monitored, and 292 (57 %) were not. The frequency of tracheal intubation was similar between monitored and non-monitored groups: ≥ 34 weeks - 13 % vs. 14 %; < 34 weeks - 43 % vs. 43 %. Electrocardiogram monitoring increased the odds of initiating PPV with a face mask ≥ 60 seconds after birth by 2.45-fold (95 % CI: 1.08–5.54) for GA ≥ 34 weeks and by 2.72-fold (95 % CI: 1.13–6.59) for GA < 34 weeks, after adjustment for umbilical cord clamping time, year of birth, and birth weight. Conclusion: Electrocardiogram monitor use did not reduce the frequency of tracheal intubation and was associated with delayed initiation of PPV with a face mask.
Abstract from DOAJ. Public domain (CC0 1.0).
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