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Prevention of sudden unexpected postnatal collapse in wellbeing newborns by remote digital health technologies
Massimo Berger1, Adalberto Brach Del Prever2, Michele Mario Calvo3
1Pediatrics and Neonatology, PO Ivrea, Azienda Sanitaria Locale Torino 4 (ASLTO4), Ivrea, Torino, Italy.
Insights
Wireless cardiopulmonary monitoring successfully prevented Sudden Unexpected Postnatal Collapse (SUPC) in newborns. This innovative approach enhanced parental serenity and demonstrated feasibility in large-scale, multicenter studies without disrupting infant bonding.
Area of Science:
- Neonatal Health
- Digital Health Technology
- Cardiopulmonary Monitoring
Background:
- Sudden Unexpected Postnatal Collapse (SUPC) is a rare but devastating event with no current diagnostic prediction model for individual newborn risk.
- There is a critical need for effective strategies to prevent SUPC and ensure newborn safety during the vulnerable postnatal period.
Purpose of the Study:
- To evaluate the feasibility of implementing wireless cardiopulmonary monitoring for all newborns in preventing SUPC.
- To assess the impact of this technology on parental acceptance, mother-infant bonding, and routine neonatal procedures.
- To demonstrate the potential for large-scale, multicenter implementation of continuous newborn monitoring.
Main Methods:
- Implementation of wireless cardiopulmonary monitoring for newborns during the first 24 hours of life across three hospitals in Northern Italy.
- Study involved approximately 2,000 newborns from June 2023 to December 2024.
- Data collection focused on system feasibility, parental acceptance, and detection of pathological events.
Main Results:
- High parental acceptance of the wireless monitoring system, with refusal in only two out of over 2,000 cases.
- The system did not interfere with skin-to-skin contact, breastfeeding attachment, or neonatal screening.
- Preliminary results in 2,250 newborns showed the detection of various pathological events, including two SUPC cases that were successfully resuscitated without neurological sequelae.
Conclusions:
- This proof-of-concept study demonstrates the feasibility and effectiveness of an innovative digital approach for early interception of SUPCs.
- Large-scale, multicenter wireless monitoring is achievable without negatively impacting the crucial initial mother-infant relationship.
- Study limitations include monitoring primarily term or late preterm infants due to hospital infrastructure.
Introduction:
To prevent the Sudden Unexpected Postnatal Collapse (SUPC) this approach was carried out. SUPC is a rare and devastating event for the child and their family. Currently, no diagnostic prediction model is available to calculate the individual newborn risk.
Patient And Methods:
To prevent SUPC, the Department of Maternal and Child Health at ASLTO4 in Piedmont, Northern Italy, has implemented wireless cardiopulmonary monitoring for all newborns during the first 24 h of life, starting on June 10th, 2023, to December 31st, 2024. The study involved approximately 2,000 newborns from three Spoke hospitals in Northern Italy. The aim of the study was to evaluate the feasibility of wireless monitoring in a large series of newborns.
Results:
On more than 2,000 newborns, we have seen parental refusal in only two cases. The system was well accepted by the families after adequate explanation of the monitoring modalities and its meaning. The wireless system has in no way hindered the skin-to-skin moment nor delayed the time of attachment to the breast and the usual neonatal screening procedures. The introduction of this new technology has brought increased serenity to parents, especially in situations of severe tiredness after troubled births or after cesarean delivery. As a very preliminary results in 2,250 newborns the monitoring system detected various pathological events, in particular two cases of SUPC which were promptly resuscitated without subsequent neurological sequelae.
Conclusions:
We report on our proof-of-concept innovative digital approach to intercept SUPCs as soon as possible. Through this study we want to demonstrate that it is possible to carry out large-scale multicenter monitoring, without interfering with breast attachment and the initial mother-infant relationship. The limitations of the study mainly concern the fact that this monitoring was carried out on term or late pre-term infants. This was due to the unavailability of a neonatal intensive care (TIN) within our hospitals and therefore severe preterm children were born or transferred early to a third level hospital.
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