The effects of noise on preterm infants in the NICU

Abstract

In this early pilot study, we sought to determine if the alteration in these physiologic effects in premature infants in response to ambient noise in the NICU could be assessed evaluating cerebral blood saturation. Three premature infants, on high flow nasal cannula oxygen support (HFNC), at less than 34 weeks of gestation were included in the study. Three variables were used to evaluate sound levels due to AAP and EPA guidelines; Leq,1h, L10,1h and Lmax,1min. All of the patients studied were found to be exposed to statistically significant noise levels (above recommendation) throughout all of the time periods measured. Noise levels were found to be similarly elevated during the 1 am and 3 pm time periods as well, though not as much as compared to the 7 am measure. A statistically significant difference was found within every patient's rSO2 levels in both hemispheres, but also in the absolute differences of rSO2. Positive significant statistical correlations were found between the average rSO2 and Leq,1h (ρ=0.14), Lmax,1min (ρ=0.18), L10,1h (ρ=0.15). Significant negative correlations were found between the absolute difference levels and Lmax,1min (ρ=-0.3), and L10,1h (ρ=-0.18) This data highlights the need for further study as to the potential impact of noise on the cerebral physiology of premature infants. Further research is needed to assess the potential long-term side effects of environmental noise on the premature in-fant's brain.

Auditory event-related potentials are related to cognition at preschool age after very preterm birth

“…The auditory environment is different between VP and term-born infants during the last trimester. Both favorable intrauterine influences and unfavorable effects of the NICU environment such as noisy ventilator support devices and disturbing alarms (19,20) may have an impact on later auditory processing.…”

Mother’s voice and heartbeat sounds elicit auditory plasticity in the human brain before full gestation

“…Numerous studies have suggested that the auditory environment available for preterm infants in the NICU may not be conducive for their neurodevelopment (44)(45)(46)(47). These concerns are Significance Newborns can hear their mother's voice and heartbeat sounds before birth.…”

Assessment of environmental noise and its effect on neonates in a Neonatal Intensive Care Unit

“…56 There is little literature studying the response of extremely pre-57 mature newborns to the habitual noise in a NICU during their first 58 days of life and not using artificial, additional sources of noise. In 59 most cases the patients are exposed to a high level of synthetic noise 60 over short intervals of time (see [7] for a summary of previous 61 research), that has little to do with the real conditions of ambient 62 noise in a NICU. Williams et al [15] …”

“…Nevertheless, 43 noise levels detected in a number of NICUs often exceed these rec- 44 ommendations [5,6], bringing with them potential risks for the 45 short and long-term development of newborns [7]. 46 Among the numerous secondary effects of excessive noise expe- 47 rienced by premature newborns whilst in hospital [8], there are 48 descriptions of changes in the cardio-respiratory system and of 49 cerebral perfusion [7,9]. Stabilizing the immature infant's cerebral 50 blood flow during the first few days of life has been put forward as 51 one of the strategies to prevent the appearance of intraventricular 52 hemorrhage (10).…”

“…There are universally accepted recommendations 42 for tolerable noise limits in neonatal units [2][3][4]. Nevertheless, 43 noise levels detected in a number of NICUs often exceed these rec- 44 ommendations [5,6], bringing with them potential risks for the 45 short and long-term development of newborns [7]. 46 Among the numerous secondary effects of excessive noise expe- 47 rienced by premature newborns whilst in hospital [8], there are 48 descriptions of changes in the cardio-respiratory system and of 49 cerebral perfusion [7,9].…”