Standardised newborn care in neonatal transport in Italy

Specialised neonatal ambulance used for emergency newborn transfers. © Montreal Children’s Hospital

Care can vary when a newborn needs urgent transfer between hospitals, and this can affect safety and access to specialist support. Therefore, a consistent approach is essential. Neonatal emergency transport services form part of a wider perinatal network, and gaps between regions can lead to unequal care. This national survey examined how transport services for newborn emergencies are organised and used across Italy. The study is relevant for parents, families, and health professionals involved in pregnancy, birth, and newborn care. Overall, the findings highlight where services are well established and where more aligned standards could improve consistency.

Neonatal transport is sometimes required even when care is planned around specialist centres. In a decentralised health system, regions organise services differently. As a result, access to standardised newborn care during transfers may vary. The study aimed to describe organisation, coverage, and activity across the country. Researchers sent a questionnaire to all identified neonatal transport teams, and all responded. The survey focused on service organisation and practice rather than medical outcomes.

Why neonatal emergency transport services require standardised newborn care

Most regions provided full coverage. However, some areas offered only partial coverage, and one region had no active service despite an approved plan. All services operated 24 hours a day, 7 days a week. Nevertheless, most relied on on-call teams drawn from neonatal intensive care staff, while only a few had dedicated transport teams.

Over one year, teams reported thousands of transports. Most involved primary transfers to higher-level care, whereas fewer involved back-transfers. Transport duration varied widely, with a median time just over 100 minutes. In addition, the availability of specific capabilities differed between regions, including nitric oxide, phototherapy, and active cooling.

Signs of standardisation were evident. For example, many services used transport databases, written guidelines, audits, and internal training. However, activity levels differed sharply. Several teams carried out low numbers of transports each year. Although some regions used air transport, it represented only a small share of total activity.

What this means for parents and health professionals

If a newborn requires transfer, parents can ask their care team whether neonatal emergency transport services are available locally and how teams staff them. In practice, health professionals can strengthen consistency by using shared guidelines, regular audits, and structured training.

Where possible, planned referral pathways within regional perinatal networks can help match newborn needs to the appropriate level of care. Finally, reviewing local standards may help parents and professionals understand how neonatal emergency transport services operate in their area.

Paper available at: https://doi.org/10.3390/children12020162

Full list of authors: Bellini, C; Gente, M; Minghetti, D; on behalf of the Neonatal Transport Study Group of the Italian Society of Neonatology

DOI: 10.3390/children12020162