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 wireless forehead-mounted reflectance photoplethysmography sensor (fhPPG), wrist-mounted transmission PPG with a pulse oximeter (wrPO) and ECG (heart rate) in 20 term newborns born via elective caesarean section, during the first 10 minutes of life.

Results

From the datasets available (n = 13), the median (IQR) sensor placement times for fhPPG, ECG and wrPO were 129 (70) seconds, 143 (68) seconds, and 159 (76) seconds 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.

Figure 1.

Conclusion

In the period of newborn transition at birth in healthy term infants, wireless 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 wireless forehead monitoring based on the potential benefits over peripheral monitoring is warranted.

Impact

• This study demonstrates the feasibility of wirelessly and 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 and wireless monitoring of vital signs from the forehead could become a valuable tool to improve the delivery of optimal care provided for newborns at birth.