Towards an educational tool for supporting neonatologists in the delivery room

The transition from fetal to extra-uterine life is characterized by a series of respiratory, cardiovascular and metabolic adaptation mechanisms. Approximately 90% of newborns breathe spontaneously without the need for interventions, the remaining 10% will need assistance at birth. Among the latter, most will start breathing after the first assistance maneuvers (drying, tactile stimulation, alignment of the airways); 5% thanks to the application of positive pressure ventilation (PPV). Estimates of intubation rates vary between 0.4% and 2%; less than 0.3% will require chest compression and approximately 0.05% will need medication [1, 4, 5, 15, 16]. Neonatal mortality in Italy, for babies born after the 22nd week of gestational age, is estimated as 1.7 deaths per 1000 births, compared to an average 2.1/1000 in Europe [11]. The inability of some infants to establish and sustain spontaneous or adequate breathing, contributes significantly to these early deaths and also to the burden of adverse neurological outcomes among survivors.