title: Lack of Association of ST-T Wave Abnormalities to Congenital Heart Disease in Neonates.
abstract: BACKGROUND
  ST-T wave (STTW) abnormalities have been described in 20-40% of normal newborns. We sought to describe the associations of these Electrocardiogram (ECG) abnormalities to perinatal course and congenital heart disease (CHD).
  
  
  METHODS
  A retrospective chart review was performed on all neonatal ECGs between January 2008 and March 2013 identified from electronic medical records. Electronic medical records were reviewed for perinatal course and maternal medical conditions. Neonates <37 weeks gestation, >3 days age, requiring hemodynamic support in the first 3 days, with oxygen saturation <90% on room air, or with arrhythmias and significant abnormalities of axis and voltage were excluded from the analysis. ST segment elevation or depression of >2 mm in at least one lead and flat or inverted T waves in at least one lead except aVR were considered abnormal. Statistical relationships were explored between STTW abnormalities, perinatal variables and CHD.
  
  
  RESULTS
  ECGs were performed on 1043 neonates, of which 664 were included. STTW abnormalities were found in 236 (35.5%) neonates. T wave abnormalities were identified in 191 (28.7%), ST segment abnormalities in 77 (11.6%) and both on 32 (4.8%) neonates. No relationship was found between the ECG abnormalities and perinatal variables, except maternal cefazolin administration during labor. Noncritical CHD was diagnosed by echocardiography in 59/84; STTW abnormalities were seen in 17/59 (29%) patients with and 9/25 (34%) without noncritical CHD, P = .6.
  
  
  CONCLUSIONS
  STTW abnormalities on ECG are commonly found in 35.5% of normal neonates and do not predict noncritical CHD.
authors.affiliation: Department of Pediatrics, Bronx Lebanon Hospital Center, Bronx, NY, USA.
authors.forename: Sudheer R
authors.initials: SR
authors.lastname: Gorla
authors.affiliation: Division of Pediatric Cardiology, Children's Hospital at Montefiore, Bronx, NY, USA.|Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: Daphne T
authors.initials: DT
authors.lastname: Hsu
authors.affiliation: Department of Pediatrics, Bronx Lebanon Hospital Center, Bronx, NY, USA. aparnapat@yahoo.com.|Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY, USA. aparnapat@yahoo.com.
authors.forename: Aparna
authors.initials: A
authors.lastname: Kulkarni
mesh_terms: D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006329:Heart Conduction System / Q000503:physiopathology*; D006330:Heart Defects, Congenital / Q000175:diagnosis* / Q000503:physiopathology; D006764:Hospitals, Community; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D018743:Perinatal Care / Q000379:methods*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013997:Time Factors
keywords: Congenital Heart Disease; Electrocardiogram; Neonates; ST-T Wave Abnormalities