Future Directions in Neonatal Technology

 Premature births can have a profound impact on the health of a child,increasing their susceptibility to common neo-natal conditions.

There are inherent difficulties associated with diagnosing and treating these conditions in newborn infants and this is one area where researchers have been looking to make strides in recent years.

Early diagnosis increases the chances of successful treatment while reducing the possibility of negative side effects, but currently detecting these conditionscan prove to be a traumatic process.

Conditions such as acid reflux, which are usually a mere inconvenience for adults, can lead to pneumonia in newborn infants, who are at particular risk if they were born pre-term.

However, diagnosing it involves inserting a tube through the nose into the oesophagus, causing understandable distress.

Researchers at Michigan State University are now working on adapting a common engineering instrument - the accelerometer - to provide a far less invasive diagnostic test.

Neonatologist Ira Gewolb is creating a device which when taped to the infant's chest will detect a low frequency sound as the reflux is backed up from the stomach to the oesophagus.

With more than half of newborns suffering from the condition, the simple test could make a significant impact, particularly on premature babies who are often prescribed medication with potential side effects to treat the condition.

Meanwhile, in the UK, technological advancements are being made which can replicate simple diagnostic tests undertaken by doctors for decades using nothing more than their senses.

Scientists in Bristol and Birmingham are creating a sensor which should allow for earlier diagnosis for a devastating condition known as necrotising enterocolitis, which affects premature babies.Up to 35 percent of babieswith the disease die while many survivors are faced with long-term health problems.

The researchers are looking to create a complex sensor to replicate the ability of doctors to smell the small quantities of gas in the infant's faeces, which occur as a result of the disease.

Dr. Andrew Ewer, from the Neonatal Unit at Birmingham Women's Hospital, explained: "In earlier work, we made an exciting discovery, which we believe could lead to a major breakthrough in the diagnosis of NEC.

"Our research found preliminary evidence that suggests the composition of a baby's faeces changes in a characteristic way if he, or she, develops NEC."

If successful, the device would allow for routine screening of babies to detect the disease and would be suitable for keeping alongside cots in neonatal units.

As with a number of medical technologies, Professor Norman Ratcliffe of theUniversity of West England told the Engineersuccess is already being seen in usingthe sensor to detect other conditions.

"We're using the same system for urine and we're getting very good initial results for diagnosing urinary tract infections and, more particularly, prostate cancer," he explained.

Yet, it is not only specifically engineered technologies which have the potential to improve the success of neonatal care.

Electronic Medical Records (EMR) have been a controversial subject, but a new study suggests they could be used to save the livesof thousands of babies each year.

Published in the Journal of Political Economy, the research suggested a 10 percent increase in the use of EMR by hospitals could save 16 babies for every 100,000 live births. It calculates if all health records in the United States were made electronic, this could save the lives of 6,400 babies a year.

The figures were based on a comparison of infant death rates in hospitals with and without electronic health records in 2,500 counties in the United States over a 12-year period, taking into account other control factors.

"This paper offers evidence that suggests cautious optimism about the potential value of … [electronic records] in improving neonatal health outcomes and current health policy that is directed towards increasing the spread of these technologies," the researchers said.

The study said EMR would allow obstetricians to better identify high-risk pregnancies and plan care accordingly, while also offering a more cost-effective solution.

Advancements being made in neonatal technology are providing solutions to long-standing problems based on existing engineering and building on the techniques medical professionals already know.

This suggests there is much room for further development in the future, which will ultimately save the lives of more newborns, in particular those which entered the world prematurely. 

[inlinead]