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. 2024 Oct 17.
doi: 10.1038/s41390-024-03651-0. Online ahead of print.

Comparing peripheral limb and forehead vital sign monitoring in newborn infants at birth

Suvvi K Narayana Swamy  1 , Simon J Stockwell  1 , Chong Liu  1 , Caroline Henry  2 , Lara Shipley  2 , Carole Ward  2 , Siavash Mirahmadi  1 , Ricardo Correia  1 , Stephen P Morgan  1 , John A Crowe  1 , Don Sharkey  2 , Barrie R Hayes-Gill  3
Affiliations

Comparing peripheral limb and forehead vital sign monitoring in newborn infants at birth

Suvvi K Narayana Swamy et al. Pediatr Res. .

Abstract

Background: To study the feasibility of measuring heart rate (HR) and oxygen saturation (SpO2) on the forehead, during newborn transition at birth, and to compare these measurements with those obtained from the wrist.

Methods: Vital signs were measured and compared between forehead-mounted reflectance (remittance) photoplethysmography sensor (fhPPG) and a wrist-mounted pulse oximeter sensor (wrPO), from 20 enrolled term newborns born via elective caesarean section, during the first 10 min of life.

Results: From the datasets available (n = 13), the median (IQR) sensor placement times for fhPPG, ECG and wrPO were 129 (70) s, 143 (68) s, and 159 (76) s, respectively, with data recorded for up to 10 min after birth. The success rate (percentage of total possible HR values reported once sited) of fhPPG (median = 100%) was higher compared to wrPO (median = 69%) during the first 6 min of life (P < 0.005). Both devices exhibited good HR agreement with ECG, achieving >95% agreement by 3 (fhPPG) and 4 (wrPO) min. SpO2 for fhPPG correlated with wrPO (r = 0.88), but there were significant differences in SpO2 between the two devices between 3 and 8 min (P < 0.005), with less variance observed with fhPPG SpO2.

Conclusion: In the period of newborn transition at birth in healthy term infants, forehead measurement of vital signs was feasible and exhibited greater HR accuracy and higher estimated SpO2 values compared to wrist-sited pulse oximetry. Further investigation of forehead monitoring based on the potential benefits over peripheral monitoring is warranted.

Impact: This study demonstrates the feasibility of continuously monitoring heart rate and oxygen saturation from an infant's forehead in the delivery room immediately after birth. Significantly higher SpO2 measurements were observed from the forehead than the wrist during the transition from foetal to newborn life. Continuous monitoring of vital signs from the forehead could become a valuable tool to improve the delivery of optimal care provided for newborns at birth.

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