Physiological vital sign ranges in newborns from 34 weeks gestation: A systematic review

Paliwoda, Michelle; New, Karen; Davies, Mark W; Bogossian, Fiona

doi:10.1016/j.ijnurstu.2017.10.004

Cited by 14 publications

(9 citation statements)

References 32 publications

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“…We identified 7 themes and 67 subthemes of outcomes. Of the 67 subthemes, 13 were systematically reviewed without a meta-analysis (via 29 reviews)13–41 (figure 2). Out of the 141 reviews with meta-analyses, 52 had a high-quality appraisal score, 61 medium and 28 low (online supplemental material 4a).…”

Section: Resultsmentioning

confidence: 99%

Effects of size at birth on health, growth and developmental outcomes in children up to age 18: an umbrella review

et al. 2023

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BackgroundSize at birth, an indicator of intrauterine growth, has been studied extensively in relation to subsequent health, growth and developmental outcomes. Our umbrella review synthesises evidence from systematic reviews and meta-analyses on the effects of size at birth on subsequent health, growth and development in children and adolescents up to age 18, and identifies gaps.MethodsWe searched five databases from inception to mid-July 2021 to identify eligible systematic reviews and meta-analyses. For each meta-analysis, we extracted data on the exposures and outcomes measured and the strength of the association.FindingsWe screened 16 641 articles and identified 302 systematic reviews. The literature operationalised size at birth (birth weight and/or gestation) in 12 ways. There were 1041 meta-analyses of associations between size at birth and 67 outcomes. Thirteen outcomes had no meta-analysis.Small size at birth was examined for 50 outcomes and was associated with over half of these (32 of 50); continuous/post-term/large size at birth was examined for 35 outcomes and was consistently associated with 11 of the 35 outcomes. Seventy-three meta-analyses (in 11 reviews) compared risks by size for gestational age (GA), stratified by preterm and term. Prematurity mechanisms were the key aetiologies linked to mortality and cognitive development, while intrauterine growth restriction (IUGR), manifesting as small for GA, was primarily linked to underweight and stunting.InterpretationFuture reviews should use methodologically sound comparators to further understand aetiological mechanisms linking IUGR and prematurity to subsequent outcomes. Future research should focus on understudied exposures (large size at birth and size at birth stratified by gestation), gaps in outcomes (specifically those without reviews or meta-analysis and stratified by age group of children) and neglected populations.PROSPERO registration numberCRD42021268843.

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Section: Resultsmentioning

confidence: 99%

Effects of size at birth on health, growth and developmental outcomes in children up to age 18: an umbrella review

et al. 2023

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“…145 Despite this, there continues to be inconsistency in what is considered a normal newborn temperature reference range. 5,61,145 Physiologically, newborns have difficulty initiating and maintaining normothermia due to their large surface area ratio, the amount of stored brown fat required to maintain thermogenesis and the influence of environmental temperatures. 146 While many thermal mechanisms are present in late preterm newborns to assist in maintaining temperature, these continue to develop to term; thus, the lower the gestation at birth, the less mature or present are these aspects.…”

Section: Temperaturementioning

confidence: 99%

Quantifying physiological vital sign differences in newborns from 34+0/7 weeks of gestation and establishment of vital sign reference ranges for the late preterm population

Paliwoda¹

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BackgroundTo ensure continued adaptation to extra-uterine life, all newborns have their physiological vital signs monitored intermittently post birth until discharge; these are tracked against predefined 'normal' reference ranges. Ascertaining an evidence base for 'normal' reference ranges is important for the early detection of deterioration in this population, who are at risk of not adapting to the extra-uterine environment due to being born prior to term. AimThe studies in this thesis aim to determine physiological vital sign reference ranges for well newborns between 34 +0/7 and 36 +6/7 weeks of gestation. ObjectivesThe objectives of the studies in this thesis were to: systematically summarise the evidence in peer-reviewed literature on physiological vital sign reference ranges for well newborns greater than or equal to 34 weeks of gestation; to review contemporary neonatal and midwifery textbooks and publicly available grey literature (i.e. organisational websites, hospital policies and early warning tools) for vital sign reference ranges pertaining to well newborns of ≥ 34 +0/7 weeks of gestation; to determine whether there are differences in vital signs in gestational age groups; and, if differences are identified, to establish physiological vital sign reference ranges for the well late preterm group and validate the reference ranges. Research DesignA systematic review of literature was initially undertaken followed by a scoping review of textbooks and grey literature to identify vital sign reference ranges for newborns ≥ 34 +0/7 weeks of gestation. Quantitative research methods were used to meet the remaining study objectives. Study One was conducted as a single site prospective observational study of 30 newborns, comprised of three gestational age groups: late preterm (34 +0/7 -36 +6/7 ), early term (37 +0/7 -38 +6/7 ), and term (39 +0/7 -40 +6/7 ). This involved continuously recording heart rate, respiratory rate, and peripheral oxygen saturation for up to six hours and periodic monitoring of temperature and blood pressure to determine whether physiological vital signs differed between the groups. The results of Study One informed the design of Study Two. This involved a shorter recording time of up to two hours and periodic monitoring of ii 0 Abstract temperature and blood pressure on 120 well, late preterm newborns in a single site prospective observational study. The reference ranges established in Study Two underwent validation in Study Three, in which a cross-sectional design was used to validate the data with data from the medical records of a group of late preterm newborns. ResultsThe searches of literature resulted in primary studies (n = 10), textbooks (n = 7) and grey literature (n = 11). Inconsistencies in and a dearth of vital sign ranges for gestational age groups other than term were identified. Details of how reference ranges were calculated were only provided in the peer reviewed literature.Study One generated a combined total of 284,542 heart rate values, 275,826 respiratory rate values...

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“…Já em uma revisão sistêmica, PALIWODA e colaboradores avaliaram os sinais vitais em RN com mais de 34 semanas. Foram selecionados quatro estudos primários que relatam PA entre vários períodos entre 1 e 14 dias (PALIWODA et al, 2018).…”

Section: )unclassified

Níveis de pressão arterial em sala de parto de recém nascidos saudáveis

Oliveira¹,

Melo²,

Haubert³

2021

PIC

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A incidência de hipertensão arterial no recém-nascido a termo varia entre 0,2 a 3%. A magnitude deste intervalo reflete a dificuldade de definir a hipertensão neonatal decorrente dos fatores: ausência de estudos prospectivos de larga escala que determinem valores de referência universalmente aceitos, variabilidade das técnicas e condições de medição da pressão arterial e influência nos valores normais de pressão arterial da idade gestacional, peso à nascença, sexo, antecedentes patológicos e o uso de medicações maternas. Objetivos: Obter percentis de pressão arterial sistólica, diastólica e média em neonatos saudáveis a termo , entre a 1ª e a 2ª hora de vida, utilizando um dispositivo oscilométrico de aferição, calculando uma escala de pressão arterial sistólica e diastólica média ao nascer; além de correlacionar o valor da pressão arterial com peso ao nascimento, idade gestacional, sexo e via de parto. Métodos: Foi realizado um estudo prospectivo de coorte de dados de prontuários do Hospital Santa Lúcia - Brasília/DF. A aferição da PA foi executada entre os primeiros 15 e 30 minutos de vida através da oscilometria automática MX-600 GE, seguindo protocolo padrão de assistência do hospital. Foram incluídos RNs a termo, sem patologias, que não necessitaram de internação na unidade de terapia intensiva neonatal. Os critérios de Exclusão foram recém nascidos prematuros ou a termo que evoluíram com desconforto respiratório que necessitaram de internação e portadores de malformações maiores. Resultados: Foram avaliadas as aferições de 800 neonatos. A via preferencial de parto na amostra estudada foi a cesárea, 85,8% dos partos, e o sexo masculino foi o mais prevalente 50,9%. As médias obtidas foram de 64,89 ± 10,7 mmHg para a pressão arterial sistólica e 37,60 ± 11,7 no sexo masculino e 66,46 ± 10,9 PA sistólica e 39,52 ± 12,3 PA diastólica para feminino. A frequência cardíaca média foi de 152,86 ± 13,5 bpm masculino e 155,56 ± 12,8 feminino. Além disso, 85,1% dos RN foram classificados como adequados para idade gestacional e 97,9% das aferições foram realizadas no membro superior direito. Conclusões: O presente estudo apesar das limitações de a não aferição por um mesma pessoa, ter uma proporção tão grande de RN nascidos de parto cesáreo que podem interferir na hemodinâmica fetal, fortalece o cuidado neonatal uma vez que permite a segurança deconhecer uma curva nacional de pressão arterial e frequência cardíaca semelhante a curvas americanas e europeias.

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Physiological vital sign ranges in newborns from 34 weeks gestation: A systematic review

Cited by 14 publications

References 32 publications

Effects of size at birth on health, growth and developmental outcomes in children up to age 18: an umbrella review

Effects of size at birth on health, growth and developmental outcomes in children up to age 18: an umbrella review

Quantifying physiological vital sign differences in newborns from 34+0/7 weeks of gestation and establishment of vital sign reference ranges for the late preterm population

Níveis de pressão arterial em sala de parto de recém nascidos saudáveis

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Physiological vital sign ranges in newborns from 34 weeks gestation: A systematic review

Cited by 14 publications

References 32 publications

Effects of size at birth on health, growth and developmental outcomes in children up to age 18: an umbrella review

Effects of size at birth on health, growth and developmental outcomes in children up to age 18: an umbrella review

Quantifying physiological vital sign differences in newborns from 34+0/7&nbsp;weeks of gestation and establishment of vital sign reference ranges for the late preterm population

Níveis de pressão arterial em sala de parto de recém nascidos saudáveis

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Quantifying physiological vital sign differences in newborns from 34+0/7 weeks of gestation and establishment of vital sign reference ranges for the late preterm population