Contemporary Evidence on Interhospital Neonatal Transport as a Potentially Sepsis-Relevant Care Interval: A Scoping Review

Background and Objectives: Neonatal sepsis is time-sensitive, yet the role of interhospital transport in its early care pathway is poorly characterised. This scoping review systematically identified and classified contemporary neonatal transport variables, interventions, and organisational practices potentially relevant to early sepsis care, examined the evidentiary proximity of the available literature to neonatal sepsis, and identified priorities for direct investigation. Materials and Methods: PubMed/MEDLINE, Embase, Scopus, Web of Science, and the Cochrane Library were searched for English-language, peer-reviewed reports published from 1 January 2020 to 30 June 2026. Google Scholar, an academic search engine, and backward citation searching supplemented the database search. Two reviewers independently screened records; a third author charted data using a predefined matrix. Findings were reported according to PRISMA-ScR and synthesised descriptively because the mapping question and non-comparable concepts and outcomes did not support a pooled estimate. Results: Thirty-nine sources of evidence were included. They covered system organisation; respiratory and procedural stabilisation; haemodynamic, metabolic, and thermal management; medication and fluid use; adverse events; environmental exposures; and communication. Evidence was predominantly indirect: 24 sources were classified as indirect clinical, seven as indirect organisational, four as indirect technical, one as indirect experiential, and three as direct transport-process/indirect sepsis-outcome evidence. Few reports addressed infection-related processes, and none established that a transport intervention independently improved sepsis-specific outcomes. Antimicrobial timing, culture status, perfusion trajectories, and structured sepsis handover were rarely reported. Conclusions: Contemporary neonatal transport research identifies measurable care processes that may matter when sepsis is suspected, but the sepsis-specific effect of transport remains unproven. Prospective multicentre studies should directly link transport-phase processes with infection-defined populations and outcomes.