Related Experiment Video
Updated: Sep 18, 2025
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Quantitative assessment of comfort and physiological responses in neonates and infants during pram transport: a pilot
Anna Trivillin1,2, Maria Elena Cavicchiolo3,4, Edoardo Passarotto5
1Department of Women's and Children's Health, University Hospital of Padua, Padua, Italy.
Insights
Mechanical vibrations during pram transport impact neonatal comfort and physiological stability. Higher vibration levels correlate with increased agitation and facial tension in infants, indicating a need for safer transport guidelines.
Area of Science:
- Neonatal physiology and environmental health
Background:
- Neonatal and infant transport exposes vulnerable populations to mechanical vibrations, a significant stressor.
- Current regulations lack specific guidelines for vibration exposure during transport, leaving its impact on physiological regulation poorly understood.
Purpose of the Study:
- To quantitatively assess infant comfort and physiological stability during pram transport across various surfaces.
- To investigate the relationship between measured vibration levels and infant behavioral and physiological responses.
Main Methods:
- Healthy neonates and infants (under 6 months) underwent a 15-minute pram walk over different surfaces.
- Vibration levels were recorded using accelerometers, and physiological parameters (SpO2, heart rate) were monitored.
- Infant comfort and physiological stability were assessed using the Transport Risk Index of Physiologic Stability and Comfort Neo Scale.
Main Results:
- Vibration levels varied by surface, with gravel surfaces yielding the highest values (1.10–2.71 m/s²).
- Increased vibration exposure correlated with higher agitation scores (r=0.601, p=0.001) and facial tension (r=0.437, p=0.011).
- Elevated heart rate was linked to alertness and movement, while lower oxygen saturation correlated with agitation and facial tension.
Conclusions:
- Mechanical vibrations during pram transport demonstrably affect neonatal behavior and physiology.
- Findings underscore the necessity for research into safe vibration exposure thresholds for neonatal transport, especially in hospital settings.
Abstract:
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/s2, 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.
