Changes in the physiological parameters of newborns in the first one hour of life


  • Shasidhar Reddy Y. Department of Paediatrics, Narayana Medical College and Hospital, Nellore, Andhra Pradesh, India
  • Abdul Mohid Syed Department of Paediatrics, Narayana Medical College and Hospital, Nellore, Andhra Pradesh, India
  • Gangadhar B. Belavadi Department of Paediatrics, Narayana Medical College and Hospital, Nellore, Andhra Pradesh, India



Heart rate, Meconium stain, Low birth weight, Temperature


Background: The transition from a fetus to a newborn is the most complex adaptation that occurs in human experience. This study assessed three physiological parameters viz. temperature (core and peripheral), oxygen saturation and heart rate so as to avoid the delay in normal transitional adaptation.

Methods: This cross-sectional observational study was done at Narayana Medical College Hospital, Nellore, Andhra Pradesh, India. A total of 150 neonates born from June 2017 to February 2018 were monitored for heart rate, oxygen saturation, core and peripheral temperature from birth to 60 minutes.

Results: Most of the mother’s (45.33%) were aged between 22 to 25 years and the mean age was 23.75±3.64 years. History of consanguineous marriage was noted in 33.33%. The mode of delivery was vaginal in 70.67% of the babies. The mean gestational age was 38.74±1.36 weeks. The birth weight among 62% of the babies was between 2.5 to 3.49 Kgs and mean birth weight was 2.81±0.49 kgs. The meconium stained liquor and requirement of resuscitation was noted in 9.33% and 10.67% respectively.

Conclusions: Significant difference was noted with regard to heart rate in babies with active resuscitation, low birth weight (<2.5 kg), meconium stained liquor and warmer care compared to normal babies. There was variation in oxygen saturation in babies who required resuscitation and warmer care, and those who had low birth weight. The mean peripheral and core temperature were different in babies with abdominal care compared to warmer care.


Rammohan A, Iqbal K, Awofeso N. Reducing neonatal mortality in India: critical role of access to emergency obstetric care. PLoS One. 2013;8(3):e57244.

Lawn JE, Kerber K, Laryea EC, Cousens S. 3.6 million neonatal deaths-what is progressing and what is not?. Semin Perinatol. 2010;34:371-86.

Wagstaff A, Lindelow M, Wang S, Zhang S. Reforming China's rural health system. World Bank; 2009.

Coson S. Womb to world. Midwifery Today 2002 Spring. Available at: Accessed 18 April 2014.

Hillman NH, Kallapur SG, Jobe AH. Physiology of transition from intrauterine to extrauterine life. Clin Perinatol. 2012;39(4):769-83.

John RR, Nayak S, Paul S. Comparison of radiant warmer care and kangaroo mother care shortly after birth on the neurobehavioral responses of the newborn. J South Asian Federation Obstet Gynaecol. 2011;3(1):53-5

Soll RF. Heat loss prevention in neonates. J Perinatol. 2008;28(S1):S57.

Knobel R, Wimmer J, Holbert D. Heat loss prevention for preterm infants in the delivery room. J Perin. 2005;25(5):304-9.

Mehta SK, Super DM, Connuck D, Salvator A, Singer L, Fradley LG, et al. Heart Rate Variability in Healthy Newborn Infants. Am J Cardiol. 2002;89(1):50-3.

Kattwinkel J, Perlman JM, Aziz K, Colby C, Fairchild K, Gallagher J, et al. American Heart Association. Neonatal resuscitation: 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Pediatrics. 2010;126(5):e1400-13.

Gupta N, Venkataseshan S. Neonatal Resuscitation Program: 2010 Guidelines-Points to Ponder. Indian Pediatr. 2013;50(1):156-7.

Fuentes RF, García CJJ, Lacadena AJ, Espinosa J, González PJ. Coefficient of variation of heart rate in the newborn during the first 2 hours of life. Differences according to type of delivery. An Esp Pediatr. 1987;27(3):165-8.

Yinger NV, Ransom EI. Why invest in newborn health, 2003. Available at: whyInvestnewborn_Eng.pdf. Accessed 20 January 2013.

Habib HS. Oxygen saturation trends in the first hour of life in healthy full-term neonates born at moderate altitude. Pak J Med Sci. 2013;29(4):903- 6.

Grover G, Berkowitz CD, Lewis RJ, Thompson M, Berry L, Seidel J. The effects of bundling on infant temperature. Pediatrics. 1994;94(5):669-73.

Chen CM. Central to Peripheral temperature differences in full-term neonates delivered vaginally and by cesarean section during the first two hours of life. Clin Neonatol. 2005;12(5):51-4.

Ylikorkala O, Pohjavuori M, Rovamo L. Fetal and neonatal prostacyclin and thromboxane in relation to mode of delivery. Arch Dis Child. 1986;61(8):766-70.

Christensson K, Siles C, Cabrera T, Belaustequi A, La Fuente P, Lagercrantz H, et al. Lower body temperature in infants delivered by cesarean section than in vaginally delivered infants. Acta Paediatr. 1993;82(2):128-31.

Hägnevik K, Faxelius G, Irestedt L, Lagercrantz H, Lundell B, Persson B. Catecholamine surge and metabolic adaptation in the newborn after vaginal delivery and cesarean section. Acta Paediatr. 1984;73(5):602-9.

Faxelius G, Lagercrantz H, Yao A. Sympathoadrenal activity and peripheral blood flow after birth: comparison in infants delivered vaginally and by cesarean section. J Ped. 1984;105(1):144-8.

Karlsson H, Hänel SE, Nilsson K, Olegärd R. Measurement of skin temperature and heat flow from skin in term newborn babies. Acta Paediatr. 1995;84(6):605-12.






Original Research Articles