Quantitative assessment of comfort and physiological responses in neonates and infants during pram transport: a pilot study

• Published in: European journal of pediatrics Vol. 184; no. 7; p. 435
• Main Authors: Trivillin, Anna, Cavicchiolo, Maria Elena, Passarotto, Edoardo, Contessa, Paola, Trevisani, Alberto, Tomasi, Ivan, Verlato, Giovanna, Baraldi, Eugenio, Masiero, Stefano, Rubega, Maria
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 23.06.2025; Springer Nature B.V
• Subjects: Agitation; Asphalt; Babies; Female; Heart Rate; Humans; Infant; Infant, Newborn; Infants; Male; Medicine; Medicine & Public Health; Neonates; Newborn babies; Oxygen saturation; Pain; Pediatrics; Physiology; Pilot Projects; Sensors; Vibration; Vibration - adverse effects; Vibrations; Well being; Safety threshold; Mechanical vibration; Neonatal comfort; Neonatal transport
• ISSN: 1432-1076; 0340-6199; 1432-1076
• DOI: 10.1007/s00431-025-06273-8

Minimizing environmental stressors is crucial for neonatal health. The American Academy of Pediatrics and the World Health Organization have issued recommendations to limit noise levels for newborns, but no specific regulations currently address vibration exposure. This study’s objective is to quantitatively assess comfort and physiological stability in neonates and infants during a pram transport. Healthy neonates and infants (< 6 months old) were enrolled for a 15-min walk using a commercially available pram over different surfaces. Vibrations were recorded using accelerometers, while physiological parameters were monitored with a neonatal SpO₂ sensor. Comfort and physiological scores were assessed using the Transport Risk Index of Physiologic Stability score and Comfort Neo Scale. Eighteen subjects (median age: 93 days, IQR [59, 158]; median weight: 5.5 kg (IQR [5, 7.5]) were included. Median vibration total value ranged from 1.10 to 2.71 m/s 2 , with the highest values recorded on gravel surfaces. Higher vibration total values correlated with greater agitation scores ( r  = .601, p  = .001) and facial tension ( r  = 0.437, p  = .011). Increased heart rate was associated with greater alertness ( r  = .559, p  = .03) and body movement ( r  = .534, p  = .039). Lower oxygen saturation correlated with increased agitation ( r  =  − .239, p  = .049) and facial tension ( r  = –.415, p  > .001). Conclusions : Mechanical vibrations during pram transport were associated with behavioral changes in neonates and infants, with higher vibration exposure correlating with greater agitation scores. These findings highlight the need for further research to define safe vibration exposure thresholds, particularly for hospital neonatal transport. What is Known: • Neonatal and infant transport, both in and out of hospitals, causes significant stress due to mechanical vibrations. However, no specific regulations address vibration exposure, and its impact on overall physiological regulation remains poorly understood. What is New: • This study included healthy newborns and infants instead of manikins, allowing a direct assessment of vital parameters and comfort in response to vibration exposure. Our findings demonstrate that different vibration levels may impact both behavioral and physiological parameters in this population.