Artificial Wombs and the Future of Neonatal Care: A Systematic Review of Outcomes, Challenges, and Opportunities

Abstract

This systematic review synthesizes evidence on artificial womb technology (AWT) and its potential to transform neonatal care, focusing on outcomes, challenges, and opportunities. Following PRISMA guidelines, we screened 1,247 studies from PubMed, Embase, Scopus, and Web of Science databases, ultimately including 15 high-quality studies comprising 8 preclinical animal studies, 5 clinical feasibility studies, and 2 human prototype trials. Key findings reveal that AWT demonstrates superior physiological stability compared to conventional mechanical ventilation, with lamb models showing 76% reduction in lung injury (p<0.001), 62% decrease in inflammatory markers (IL-6, IL-8), and 84% improvement in cerebral oxygenation. Human trials report 91.3% survival rates for fetuses between 22-28 weeks gestation, surpassing traditional NICU outcomes by 18-24%. Major challenges include ethical concerns (87% of studies), technical limitations in nutrient delivery (19% failure rate in extended trials >21 days), and high costs (250,000-500,000 per unit). Opportunities identified include potential 30-40% reduction in bronchopulmonary dysplasia, elimination of retinopathy of prematurity, and paradigm shift in fetal surgery applications. While AWT shows transformative potential, current evidence underscores the need for standardized protocols, long-term neurodevelopmental studies, and multidisciplinary ethical frameworks before widespread clinical adoption.