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Comparison of infant heart rate assessment by auscultation, ECG and oximetry in the delivery room
  1. Madeleine C Murphy1,2,3,
  2. Laura De Angelis4,
  3. Lisa K McCarthy1,5,
  4. Colm Patrick Finbarr O’Donnell1,2,5,3
  1. 1 Neonatal Unit, The National Maternity Hospital, Dublin, Ireland
  2. 2 National Children’s Research Centre, Dublin, Ireland
  3. 3 School of Medicine, University College Dublin, Dublin, Ireland
  4. 4 Vittore Buzzi Hospital, University of Milan, Dublin, Ireland
  5. 5 Department of Neonatology, Our Lady’s Children’s Hospital, Dublin, Ireland
  1. Correspondence to Professor Colm Patrick Finbarr O’Donnell, The National Maternity Hospital, Dublin D02 YH21, Ireland; codonnell{at}


Clinical assessment of an infant’s heart rate (HR) in the delivery room (DR) has been reported to be inaccurate. We compared auscultation of the HR using a stethoscope with electrocardiography (ECG) and pulse oximetry (PO) for determining the HR in 92 low-risk newborn infants in the DR. Caregivers auscultated the HR while masked to the HR on the monitor. Auscultation underestimated ECG HR (mean difference (95% CI) by −9 (−15 to –2) beats per minute (bpm)) and PO HR (mean difference (95% CI) by −5 (−12 to 2) bpm). The median (IQR) time to HR by auscultation was 14 (10–18) s. As HR was determined quickly and with reasonable accuracy by auscultation in low-risk newborns, study in high-risk infants is warranted.

  • infant
  • newborn
  • electrocardiogram
  • clinical assessment of heart rate
  • pulse oximetry

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  • Contributors MCM participated in study concept, study design, data collection, data analysis and writing of the first draft of the manuscript. LDA participated in data collection. LKM participated in study design, data analysis and revision of the manuscript. CPFO participated in study concept, study design, data analysis and revision of the manuscript.

  • Funding MCM is supported by a Clinical Research Fellowship from the National Children’s Research Centre (R17637).

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval National Maternity Hospital Research Ethics Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.