Towards an acoustic assessment of the neonatal lung status based on the first vocalisations

Objective: The vocalisations of newborns produced immediately after birth cause that a part of the exhaled air is reflected at the largely closed vocal folds and streams back into the lungs. This so-called pendelluft flow supports the displacement of the amniotic fluid into the interstitium, and, thereby, plays an essential role for reaching a stable breathing function after a few minutes of extrauterine life (Tingay et al., 2021). Reflecting different states of lung development, there are reported audible differences between the first vocalisations of term and pre-term newborns, or generally, of healthy newborns and newborns with respiratory problems. Nevertheless, the relationship between the neonatal state of lung development and objective characteristics of the first vocalisations of newborns has not yet been studied. Therefore, this pilot work aimed to provide the first description of selected acoustic voice parameters as well as the temporal distribution of newborn vocalisations produced during the first minutes after birth as a function of the gestational age [1].

Materials and methods: Audio recordings were conducted in the delivery room during the first minutes of extrauterine life of term and pre-term newborns (ongoing data acquisition; planned N=16). All participants were born by vaginal birth at the Division of Obstetrics, University Hospital of Graz, Austria. Newborn vocalisations were manually segmented and annotated for vocalisation types by two independent raters. For each participant, the type-specific number of vocalisations and their temporal distributions over the first minutes of life, as well as the interval between the time of birth and the first vocalisation were extracted. For each vocalisation, the duration as well as five acoustic standard voice parameters, i.e., loudness, fundamental frequency, jitter, shimmer, and harmonics-to-noise ratio, were computed. Finally, the relationship between the derived characteristics and the gestational age was investigated and interpreted in the context of additionally collected information about pre-existing conditions of the parents as well as information about pregnancy, birth (e.g., birth weight and size, APGAR score, etc.), and the early neonatal phase.

Results and Conclusion: For the very first time, benchmark values and ranges of objective characteristics of the first vocalisations of newborns are presented by comparing different gestational ages across the pre-term and term periods. Single vocalisation characteristics turned out to reflect the gestational age at the time of birth, indicating their potential relevance for an acoustic assessment of the neonatal lung status. These findings represent a first important grain of knowledge for the development of a future tool to automatically and non-invasively identify newborns with respiratory problems immediately after birth just from their first vocalisations by means of audio signal processing and artificial intelligence.

Publication History

Article published online:
19 May 2025

• Literatur

• 1 Tingay D.G., Farrell O., Thomson J., Perkins E.J., Pereira-Fantini P.M., Waldmann A.D., Rüegger C., Adler A., Davis P.G., Frerichs I.. Imaging the respiratory transition at birth: Unraveling the complexities of the first breaths of life. American Journal of Respiratory and Critical Care Medicine 2021; 204: 82-91