The early days of a child’s life are memorable for all parents, but the experience can become much more complicated and stressful if their child is born too soon.
Premature babies suffer from significant health risks, and caring for them is complex and expensive. It also uses technology which scientists say hasn’t fundamentally changed for decades, requiring extensive wires and tubes in a Neonatal Intensive Care Unit (NICU).
But researchers have now developed ultra-light and discreet wireless sensors to monitor the vital signs of premature babies, such as heart rate and temperature, which is currently done using intrusive NICU equipment.
The technology also received funding from the Gates Foundation and Save The Children, in the hope it could boost neonatal healthcare in low-resource settings. Trials of the patches in India, Zambia, Kenya and Pakistan for this year are being discussed.
Free from wires
The research, carried out by a team of scientists mostly based at Northwestern University, Chicago, was published in the journal Science earlier this month.
The sensors are soft “skin-like” patches stuck to the chest and foot using water and are a thousand times easier to remove than traditional adhesives, according to the scientists. They are powered wirelessly and connect to an app which displays all the baby’s vital signs. The devices also record blood pressure, which usually requires additional painful procedures.
Not only will the cutting-edge sensors mean premature babies look less medicalised — seeing their newborns covered in wires can be disturbing for some parents — but will also allow for skin-to-skin contact between mother and child, which has a range of health benefits.
“A baby born at 25 weeks is essentially a giant wound”
The scientists also say their patches are easy to use, reusable and will exploit mobile and cloud technology to create a “NICU ready to go” on common devices, said Dr Steve Xu, a study author and a physician-engineer who also specialises in dermatology.
Sixty babies have already worn the patches, which were specially developed in the university laboratory. “We haven’t a single serious adverse event,” said Xu.
Too many deaths
Each year, there are 15 million premature births worldwide and complications arising from them are the leading cause of deaths in children under five, according to the World Health Organisation (WHO).
In 2015, preterm birth complications were responsible for the death of a million babies, the organisation said.
“If you look at global mortality trends over time, everything is moving downwards except for the group of newborns which has either stayed pretty consistent over time or is even on the rise a bit,” said Kate Fay, Associate Program Officer of Discovery and Translational Sciences at the Bill and Melinda Gates Foundation
She told Apolitical the device has the potential to “address capacity gaps” in developing healthcare contexts and “identify risk as early as possible”.
Neonatal intensive care also presents unique challenges, which may be exacerbated in low resource settings.
“A premature baby born at 25 weeks with underdeveloped skin, the baby is essentially a giant wound,” says Xu. “Imagine a whole top layer of skin that is raw and not developed.”
Equipment currently used in NICUs can worsen this. “15% of a [premature] baby’s skin, their total body surface area, is traumatised every day by the very adhesives and devices keeping that baby alive,” Xu adds.
Current NICU equipment also prevents parents from having skin-to-skin contact with their child. Despite the apparent simplicity of the practice, it has real medical value: Xu describes it as “one of the most powerful therapeutic agents we have in neonatology.”
“Skin to skin contact is essentially fundamental to survival”
Through skin-to-skin contact, Xu says, “the heart rate and stabilises and normalises, breathing improves, they sleep better, eat better, gain weight, and less time is spent in the NICU overall.”
As premature babies can’t regulate their own temperature, in contexts where expensive incubators may be lacking, such as hospitals in low-income countries, skin-to-skin contact is potentially “fundamental to their survival,” Xu says.
NICU monitoring equipment is widely viewed as the main impediment to skin-to-skin contact.
“Wires can present a real practical barrier for parents getting more involved with their baby’s care,” says Caroline Lee-Davey, Chief Executive of Bliss, a UK charity focused on premature and sick babies.
The components making up the sensors cost less than $20, according to Xu, who says that would be a realistic price tag for the final product. They are also scalable as production will take advantage of advances in the development and manufacturing of consumer electronics.
This means that the patches could be highly impactful in NICU units in low-income countries. The researchers say this was a consideration from the outset of their work, and received funding from Save The Children and the Gates Foundation, both international NGOs focused heavily on the developing countries.
Healthcare facilities in these places tend to be “very, very busy and very understaffed,” says Fay from the Gates Foundation.
She continues: “So having a device or sensor that can track multiple parameters at one time that can then feed into some kind of tablet or remote system to flag when a baby isn’t doing well is huge.”
“Because its battery-powered you’re not reliant on local electricity sources or generators. It really just allows clinicians and health workers to know when the sickest babies are getting sicker.”
Study leader John Rogers, professor of biomedical science at Northwestern University, anticipates the main challenges of the next phase of trials to be environmental, with the possibility of different standards to the “very controlled” environment of US hospitals where testing has so far been done.
The hot and humid climates may test the universal suitability to the patch’s adhesiveness, along with possible challenges posed by dust or cleanliness, he adds.
While much work remains and unforeseen challenges may still occur, the scientists are happy about the performance of the patches and the potential for large scale production.
“It’s on a very promising trajectory for continued reductions in cost, size, weight and power,” says Rogers. “We’re very optimistic.” — Will Worley
(Picture credit: Pixabay)