Prevention of sudden unexpected postnatal collapse in wellbeing newborns by remote digital health technologies

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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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