Not a Quiet Place: Understanding Noise Level in a Newborn Intensive Care Unit (NICU) and Its Relation with Newborn’s Vital Parameters, a Pilot Feasibility Study

<b>Background/Objectives:</b> Adaptation to extrauterine life is challenging for preterm newborns. Environmental stimuli, such as noise, can lead to adverse health outcomes, causing instability of vital parameters and impairment of neurodevelopment. The American Academy of Pediatrics recommends a maximum environmental noise level of 45 decibels (dB) or less in the NICU. The study's primary aim was to describe environmental noise in a neonatal intensive care unit and to analyze potential associations between noise and vital parameters of preterm newborns, including heart rate, respiratory rate, and oxygen saturation levels. <b>Methods</b>: A pilot observational feasibility study was conducted in a level III NICU. Sound levels and vital parameters were recorded over four hours for each preterm newborn. Confounding variables were controlled. Data were analyzed using descriptive statistics, Kendall's τ-b, and logistic regression analysis. Ethical approval and parental consent were obtained. <b>Results</b>: The average environmental noise level was consistently above 45 dB. Six patients were enrolled, and 22 recordings (ranging in length from 1 to 4 h) were performed. Data adjusted for confounding variables show a statistically significant Kendall's correlation between heart rate and decibels (τ-b = 0.89, <i>p</i> = 0.003, n = 520), suggesting a monotonous crescent tendency between these two variables, although the relationship is not strong. The logistic regression model indicates that the odds ratio (OR) for decibels related to tachycardia is 1.066, meaning that for each 1 dB increase, the probability of tachycardia rises by 6.6% (<i>p</i> < 0.001). Conversely, the OR for respiratory rate is 0.959, suggesting that for each unit increase in respiratory rate, the probability of tachycardia decreases by approximately 4.1% (<i>p</i> < 0.001). <b>Conclusions</b>: The study reveals that the mean environmental noise level in the NICU consistently exceeds the recommended safety level. Decibels are one of the significant variables contributing to the likelihood of tachycardia, and an increase in decibels has a significant effect on this, but it is not the only one. Further analysis of a larger sample is needed.

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Publication Details

Journal
Children
Published
2025-06-11
DOI
https://doi.org/10.3390/children12060757
Primary Topic
Healthcare Technology and Patient Monitoring
Type
article
Field-Weighted Citation Impact
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article

Not a Quiet Place: Understanding Noise Level in a Newborn Intensive Care Unit (NICU) and Its Relation with Newborn’s Vital Parameters, a Pilot Feasibility Study

Roberta Da Rin Della Mora, Ilaria Artuso, Silvia Scelsi, Giulia Ottonello et al.
Children
Healthcare Technology and Patient Monitoring
article

Not a Quiet Place: Understanding Noise Level in a Newborn Intensive Care Unit (NICU) and Its Relation with Newborn’s Vital Parameters, a Pilot Feasibility Study

Roberta Da Rin Della Mora, Ilaria Artuso, Silvia Scelsi, Giulia Ottonello, Andrea Salvatore, Simona Serveli, Silvia Rossi
article en

Abstract

<b>Background/Objectives:</b> Adaptation to extrauterine life is challenging for preterm newborns. Environmental stimuli, such as noise, can lead to adverse health outcomes, causing instability of vital parameters and impairment of neurodevelopment. The American Academy of Pediatrics recommends a maximum environmental noise level of 45 decibels (dB) or less in the NICU. The study's primary aim was to describe environmental noise in a neonatal intensive care unit and to analyze potential associations between noise and vital parameters of preterm newborns, including heart rate, respiratory rate, and oxygen saturation levels. <b>Methods</b>: A pilot observational feasibility study was conducted in a level III NICU. Sound levels and vital parameters were recorded over four hours for each preterm newborn. Confounding variables were controlled. Data were analyzed using descriptive statistics, Kendall's τ-b, and logistic regression analysis. Ethical approval and parental consent were obtained. <b>Results</b>: The average environmental noise level was consistently above 45 dB. Six patients were enrolled, and 22 recordings (ranging in length from 1 to 4 h) were performed. Data adjusted for confounding variables show a statistically significant Kendall's correlation between heart rate and decibels (τ-b = 0.89, <i>p</i> = 0.003, n = 520), suggesting a monotonous crescent tendency between these two variables, although the relationship is not strong. The logistic regression model indicates that the odds ratio (OR) for decibels related to tachycardia is 1.066, meaning that for each 1 dB increase, the probability of tachycardia rises by 6.6% (<i>p</i> < 0.001). Conversely, the OR for respiratory rate is 0.959, suggesting that for each unit increase in respiratory rate, the probability of tachycardia decreases by approximately 4.1% (<i>p</i> < 0.001). <b>Conclusions</b>: The study reveals that the mean environmental noise level in the NICU consistently exceeds the recommended safety level. Decibels are one of the significant variables contributing to the likelihood of tachycardia, and an increase in decibels has a significant effect on this, but it is not the only one. Further analysis of a larger sample is needed.

ChildrenVol. 12(6)
Istituto Giannina Gaslini (IT)
Regione Liguria
Openalex Percentile: Top 77%
Healthcare Technology and Patient Monitoring
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