journal article·2026-01-28Open access

Artificial Intelligence in Neonatal Respiratory Care: Current Applications and Future Directions

Aikaterini Nikolaou, Maria Baltogianni, Niki Dermitzaki, Nikitas Chatzigiannis, Dimitra Savidou, Sevastianos Geitonas, Lida-Eleni Giaprou, Vasileios Giapros

Applied Sciences· Volume 16· Issue 3

Abstract

Respiratory disorders remain a major cause of morbidity and mortality in neonatal intensive care units, particularly among preterm infants. Advances in physiological monitoring, medical imaging, and electronic health records have enabled the growing application of artificial intelligence in neonatal respiratory care. This narrative review summarizes current applications and emerging directions of artificial intelligence in the diagnosis, monitoring, and management of neonatal respiratory disorders. Machine learning and deep learning approaches have demonstrated promising performance in respiratory distress syndrome, bronchopulmonary dysplasia, apnea of prematurity, ventilatory management, and severe respiratory complications. By integrating multimodal clinical, physiological, and imaging data, these methods support earlier detection of respiratory deterioration and improved clinical decision-making. However, challenges related to data quality, generalizability, interpretability, and limited prospective validation continue to constrain widespread clinical implementation, highlighting the need for careful integration into neonatal care workflows.
Source: crossref · Quality: baseline

Research context

OpenAlex topics: Neonatal Respiratory Health Research · Respiratory Support and Mechanisms · Non-Invasive Vital Sign Monitoring

SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.

Affiliations

Neonatal Intensive Care Unit, School of Medicine, University of Ioannina, 45500 Ioannina, Greece

References (42)

Show source-provided references
1. Predicting Clinical Outcomes Using Artificial Intelligence and Machine Learning in Neonatal Intensive Care Units: A Systematic Review10.1038/s41372-022-01392-8 ↗
2. Artificial Intelligence and Informatics in Neonatal Resuscitation10.1016/j.semperi.2024.151992 ↗
3. Follow-up of neonatal chronic respiratory disease: An update based on the current evidence10.1007/s00431-025-06713-5 ↗
4. Artificial intelligence-driven wearable technologies for neonatal cardiorespiratory monitoring. Part 2: Artificial intelligence10.1038/s41390-022-02417-w ↗
5. Rallis, D., Baltogianni, M., Kapetaniou, K., and Giapros, V. (2024). Current Applications of Artificial Intelligence in the Neonatal Intensive Care Unit. BioMedInformatics, 4.10.20944/preprints202404.0177.v1 ↗
6. Neonatal intensive care decision support systems using artificial intelligence techniques: A systematic review10.1007/s10462-018-9635-1 ↗
7. Deep-learning-based multi-class classification for neonatal respiratory diseases on chest radiographs in neonatal intensive care units10.1159/000545107 ↗
8. Deep learning approaches for automated classification of neonatal lung ultrasound with assessment of human-to-AI interrater agreement10.1016/j.compbiomed.2024.109315 ↗
9. Clinical and imaging data-based machine learning for early diagnosis of bronchopulmonary dysplasia: A meta-analysis10.2174/0115734056421036250806053617 ↗
10. Bronchopulmonary dysplasia prediction models: A systematic review and meta-analysis with validation10.1038/s41390-022-02451-8 ↗
11. Yoneda, K., Seki, T., Kawazoe, Y., Ohe, K., Takahashi, N., and on behalf of the Neonatal Research Network of Japan (2024). Immediate postnatal prediction of death or bronchopulmonary dysplasia among very preterm and very low birth weight infants based on gradient boosting decision trees algorithm: A nationwide database study in Japan. PLoS ONE, 19.10.1371/journal.pone.0300817 ↗
12. Central apnea detection in premature infants using machine learning10.1016/j.cmpb.2022.107155 ↗
13. Predicting extubation readiness in preterm infants utilizing machine learning: A diagnostic utility study10.1016/j.jpeds.2024.114043 ↗
14. Artificial Intelligence-Driven Wearable Technologies for Neonatal Cardiorespiratory Monitoring: Part 1—Wearable Technology10.1038/s41390-022-02416-x ↗
15. Jha, T., Suhail, S., Northcote, J., and Moreira, A.G. (2025). Artificial intelligence in bronchopulmonary dysplasia: A review of the literature. Information, 16.10.3390/info16040262 ↗
16. Artificial intelligence–driven respiratory distress syndrome prediction for very low birth weight infants: Korean multicenter prospective cohort study10.2196/47612 ↗
17. Bronchopulmonary dysplasia predicted at birth by artificial intelligence
18. Kim, Y., Kim, H., Choi, J., Cho, K., Yoo, D., Lee, Y., Park, S.J., Jeong, M.H., Jeong, S.H., and Park, K.H. (2023). Early prediction of need for invasive mechanical ventilation in the neonatal intensive care unit using artificial intelligence and electronic health records: A clinical study. BMC Pediatr., 23.10.1186/s12887-023-04350-1 ↗
19. Jeffreys, E., Jenkinson, A., Dassios, T., and Greenough, A. (2025). Can Artificial Intelligence Predict Failure of Non-Invasive Respiratory Support in the Neonatal Unit?. Semin. Fetal Neonatal Med.10.1016/j.siny.2025.101683 ↗
20. Jenkinson, A.C., Dassios, T., and Greenough, A. (2023). Artificial Intelligence in the NICU to Predict Extubation Success in Premature Infants. J. Perinat. Med.10.1515/jpm-2023-0454 ↗
21. Artificial Intelligence to Improve Health Outcomes in the NICU and PICU: A Systematic Review10.1542/hpeds.2021-006094 ↗
22. From computer to bedside: Involving neonatologists in artificial intelligence models for neonatal medicine10.1038/s41390-022-02413-0 ↗
23. Interobserver variation in interpreting chest radiographs for the diagnosis of acute respiratory distress syndrome10.1164/ajrccm.161.1.9809003 ↗
24. Improving Neonatal Care with AI: Class Weight Optimization for Respiratory Distress Syndrome Prediction in Very Low Birth Weight Infants
25. Development and Validation of a Pre-Trained Language Model for Neonatal Morbidities: A Retrospective, Multicentre, Prognostic Study10.1016/j.landig.2025.100926 ↗
26. Machine learning-based risk prediction models for bronchopulmonary dysplasia in preterm infants: A high-altitude cohort study10.1136/bmjpo-2025-003652 ↗
27. Lei, J., Sun, T., Jiang, Y., Wu, P., Fu, J., Zhang, T., and McGrath, E. (2021). Risk identification of bronchopulmonary dysplasia in premature infants based on machine learning. Front. Pediatr., 9.10.3389/fped.2021.719352 ↗
28. Deep learning model for prediction of bronchopulmonary dysplasia in preterm infants using chest radiographs10.1007/s10278-024-01050-9 ↗
29. Bridging the gap in neonatal care: Evaluating AI chatbots for chronic neonatal lung disease and home oxygen therapy management10.1002/ppul.71020 ↗
30. Leveraging Artificial Intelligence for Prediction of Pulmonary Hemorrhage in Preterm Infants10.1038/s41372-025-02390-2 ↗
31. Early Prediction of Mechanical Ventilation Needs in Very Preterm Neonates Using Machine Learning10.1002/ppul.71195 ↗
32. Automated Hypoxia and Apnea Identification for Neonates via Enhanced Respiratory Signal Modeling with Deep Learning10.1038/s41598-025-24783-1 ↗
33. Deep learning models for early and accurate diagnosis of ventilator-associated pneumonia in mechanically ventilated neonates10.1016/j.compbiomed.2025.109942 ↗
34. Opportunities and challenges of using artificial intelligence in predicting clinical outcomes and length of stay in neonatal intensive care units: Systematic review10.2196/63175 ↗
35. Advances in Management of Non-Invasive Ventilation for Preterm Infants10.1016/j.semperi.2025.152060 ↗
36. Development of an artificial intelligence-assisted system for tracheal intubation using a video laryngoscope in infants and neonates10.1016/j.jclinane.2025.111914 ↗
37. Glottic Opening Detection Using Deep Learning for Neonatal Intubation10.1038/s41372-024-02171-3 ↗
38. Transforming neonatal care with artificial intelligence: Challenges, ethical consideration, and opportunities10.1038/s41372-023-01848-5 ↗
39. The possible role of artificial intelligence in deciding postnatal steroid management in extremely premature ventilated infants10.3233/NPM-230061 ↗
40. Sensi, F., Lizzi, F., Chincarini, A., Binelli, C., Sartori, L., and Retico, A. (2025). Augmenting, not replacing: Clinicians’ perspectives on AI adoption in healthcare. Appl. Sci., 15.10.3390/app152312405 ↗
41. Predicting neonatal respiratory distress syndrome and hypoglycaemia prior to discharge: Leveraging health administrative data and machine learning10.1016/j.jbi.2020.103651 ↗
42. Evaluating the Explainable AI Method Grad-CAM for Breath Classification on Newborn Time Series Data10.1016/j.ifacol.2024.11.023 ↗