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Assessment of breath sounds at birth using digital stethoscope technology

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Abstract

Newborn transition is a phase of complex change involving lung fluid clearance and lung aeration. We aimed to use a digital stethoscope (DS) to assess the change in breath sound characteristics over the first 2 h of life and its relationship to mode of delivery. A commercially available DS was used to record breath sounds of term newborns at 1-min and 2-h post-delivery via normal vaginal delivery (NVD) or elective caesarean section (CS). Sound analysis was conducted, and two comparisons were carried out: change in frequency profiles over 2 h, and effect of delivery mode. There was a significant drop in the frequency profile of breath sounds from 1 min to 2 h with mean (SD) frequency decreasing from 333.74 (35.42) to 302.71 (47.19) Hz, p < 0.001, and proportion of power (SD) in the lowest frequency band increasing from 0.27 (0.11) to 0.37 (0.15), p < 0.001. At 1 min, NVD infants had slightly higher frequency than CS but no difference at 2 h.

Conclusion: We were able to use DS technology in the transitioning infant to depict significant changes to breath sound characteristics over the first 2 h of life, reflecting the process of lung aeration.

What is Known:

• Lung fluid clearance and lung aeration are critical processes that facilitate respiration and mode of delivery can impact this

• Digital stethoscopes offer enhanced auscultation and have been used in the paediatric population for the assessment of pulmonary and cardiac sounds

What is New:

• This is the first study to use digital stethoscope technology to assess breath sounds at birth

• We describe a change in breath sound characteristics over the first 2 h of life and suggest a predictive utility of this analysis to predict the development of respiratory distress in newborns prior to the onset of symptoms

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Abbreviations

CS:

Elective caesarean section

DS:

Digital stethoscope

HBF:

High-frequency band

LBF:

Low-frequency band

MBF:

Medium-frequency band

MF:

Mean frequency

NICU:

Neonatal Intensive Care Unit

NVD:

Normal vaginal delivery

P25:

25th quartile

P50:

50th quartile

P75:

75% quartile

RD:

Respiratory distress

SCN:

Special care nursery

TP:

Total power

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Acknowledgements

We would like to thank the midwifery team at Monash Medical Centre and Casey Hospital for their support and assistance during the recruitment period of this study.

Funding support

Dr. Atul Malhotra is supported by a Royal Australasian College of Physicians Research Fellowship.

Author information

Authors and Affiliations

  1. Department of Paediatrics, Monash University, Melbourne, Australia

    Ashwin Ramanathan, Kenneth Tan, Robert Roseby, Ajay Kevat & Atul Malhotra

  2. Department of Electrical and Computer Systems Engineering, Monash University, Melbourne, Australia

    Faezeh Marzbanrad, Fatema-Tuz Zohra & Mathieu Acchiardi

  3. Monash Newborn, Monash Children’s Hospital, Melbourne, Australia

    Kenneth Tan & Atul Malhotra

  4. The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Australia

    Kenneth Tan & Atul Malhotra

  5. Bordeaux Institute of Technology (Bordeaux INP), Talence, France

    Mathieu Acchiardi

  6. Department of Paediatric Respiratory Medicine, Monash Children’s Hospital, Melbourne, Australia

    Robert Roseby

Authors
  1. Ashwin Ramanathan
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  2. Faezeh Marzbanrad
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  3. Kenneth Tan
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  4. Fatema-Tuz Zohra
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  5. Mathieu Acchiardi
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  6. Robert Roseby
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  7. Ajay Kevat
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  8. Atul Malhotra
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Contributions

We confirm that all authors have contributed to the concept (AR, KT, RR, AK, FM, AM), design (AR, AK, FM, AM), collection (AR AM), analysis (AR, KT, FTZ, MA, FM, AK, AM) or interpretation (AR, KT, FM, AK, AM) of the data, and have had a role in drafting or revising the article. All authors have endorsed the final version of manuscript as submitted.

Corresponding author

Correspondence to Atul Malhotra.

Ethics declarations

The study was approved by the Monash Health Human Research Ethics Committee (HREC/18/MonH/116).

Conflict of interest

The authors declare that they have no conflicts of interest.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Disclaimer

We acknowledge that the work presented is original research and the study is not under consideration for publication anywhere else and has not been published previously.

Additional information

Communicated by Patrick Van Reempts

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Ramanathan, A., Marzbanrad, F., Tan, K. et al. Assessment of breath sounds at birth using digital stethoscope technology. Eur J Pediatr 179, 781–789 (2020). https://doi.org/10.1007/s00431-019-03565-8

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  • DOI: https://doi.org/10.1007/s00431-019-03565-8

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