How comfortable is neonatal transport?

Discomfort and stress have been widely studied in the newborn baby but data are lacking for the infant undergoing transport. The aim of our study was to identify infant discomfort during road transport and its pattern.

This was a prospective cohort study on all infants transported by the Yorkshire Neonatal Transport Service over a 6-month period. The same environmental measures were used for each baby. The premature infant pain profile was used to measure stress and discomfort at five specified times during transport. The score before any intervention was the gold standard.

Of 239 transport episodes, 140 had complete data. Twenty-four babies were ventilated and routinely sedated with morphine, and the remaining babies had no pain relief. The same pattern of premature infant pain profile (PIPP) score was seen in all infants regardless of gestation or sedation. The raw PIPP scores (and data when ranked) peaked during road transport, and this was a significant change compared to baseline observations. This pattern was consistent across all gestational age groups. The sedated/ventilated babies showed the same pattern although it was blunted.

All babies showed higher levels of discomfort during transport compared to baseline. More work is needed to develop interventions that could potentially decrease this.