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Updated: May 29, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
How comfortable is neonatal transport?
1Department of Neonatal Medicine, Leeds Teaching Hospitals Trust, UK. catherine.harrison@leedsth.nhs.uk
Insights
Infant road transport causes significant discomfort and stress, as measured by the Premature Infant Pain Profile (PIPP) score. This pain pattern was consistent across all infants, regardless of gestational age or sedation.
Area of Science:
- Neonatal care
- Transport medicine
- Pediatric pain assessment
Background:
- Limited data exists on infant discomfort during transport.
- Neonatal transport is a critical but potentially stressful event for infants.
Purpose of the Study:
- To identify and characterize infant discomfort during road transport.
- To establish a pattern of discomfort in transported infants.
Main Methods:
- Prospective cohort study of infants transported by a neonatal service.
- Utilized the Premature Infant Pain Profile (PIPP) to measure stress.
- Assessed PIPP scores at five intervals during transport, comparing to baseline.
Main Results:
- Higher PIPP scores observed during road transport compared to baseline.
- Discomfort peaked during transport across all infants, irrespective of gestational age or sedation.
- Sedated/ventilated infants showed a blunted, but similar, pattern of increased discomfort.
Conclusions:
- Transporting infants leads to increased discomfort and stress.
- Further research is needed to develop interventions to mitigate transport-related distress in infants.
Aims:
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.
Methods:
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.
Results:
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.
Conclusion:
All babies showed higher levels of discomfort during transport compared to baseline. More work is needed to develop interventions that could potentially decrease this.
