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t be recommended in prehospital setting. Prospero (CRD4202127371. Premature and sick neonates may require weeks of hospitalization in a noisy neonatal intensive care unit (NICU) environment with sound levels that may reach 120 decibels. The American Academy of Pediatrics recommends a maximum sound level of 45 decibels. To measure sound levels in a level III NICU and to describe contributing environmental factors. Descriptive quantitative study. Sound levels were measured using a portable sound meter in an open-bay level III NICU. Contr