Each year, thousands of newborns worldwide require emergency transport from the hospital where they are born to receive higher-level care at a tertiary center. Newborn transport is conducted via road, fixed-wing, and rotary-wing aircraft. During transport, these babies are often exposed to higher-than-desirable levels of noise, acceleration and deceleration forces, vibration, and significant variations in ambient temperature.

Transported preterm infants have a substantially increased risk of brain injury (intraventricular hemorrhage) and death. Term infants who experience asphyxia at birth are significantly more likely to achieve therapeutic temperature if born outside a tertiary center and have a higher likelihood of increased seizure burden. Transported infants also face an increased risk of early-life deterioration compared to those not transported. These examples demonstrate that babies requiring intensive care and transport early in life are at risk of severe complications and long-term consequences.

Neonatal transport research is an emerging field. Given that these infants are at considerable risk of long-term health deficits, active investigation is urgently needed to understand the differences between transported and non-transported infants and to develop strategies to improve outcomes in this population. This special edition aims to engage with clinical investigators and provide a platform for these essential areas of research.

This publication hub for neonatal transport research will include:

• Maternal presentation
• Logistic considerations, including timings and organization of transport services
• Clinical considerations during transport
• Data considerations for research and quality improvement
• Observation and intervention studies targeting or improving outcomes

We welcome diverse publications in neonatal transport, covering various investigative needs and topics, as outlined for authors:

• Describing and understanding the retrieval environment, including physical factors influencing physiology and outcomes
• Describing the management of thermal care and optimization in the retrieval environment, including:
Therapeutic hypothermia for asphyxia
Maintaining euthermia in preterm or low birth weight infants
• Neuroprotection: understanding risks and improving neurological outcomes in preterm infants and those treated for birth asphyxia
• Respiratory management in the retrieval environment
• Optimizing pain and discomfort during transport
• Perinatal profiles of transported infants and management of at-risk in utero transfers
• The epidemiology and management of surgical infant transfers
• The epidemiology and management of cardiac infant transfers
• Preclinical research to inform neonatal transport care
• Interventional studies in neonatal transport

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Frontiers in Pediatrics

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