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Updated: Feb 9, 2026

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Post-discharge outcomes of failed car seat tolerance screens: A case-control and follow-up study

P Sharma1, N L Davis1,2

  • 1University of Maryland School of Medicine, Baltimore, MD, USA.

Journal of Neonatal-Perinatal Medicine
|May 31, 2018
PubMed

Insights

Infants who failed the Car Seat Tolerance Screen (CSTS) showed higher rates of respiratory issues like asthma and obstructive sleep apnea (OSA) years later. This suggests CSTS may help identify high-risk neonates for closer monitoring.

Area of Science:

  • Neonatal medicine
  • Pediatric pulmonology
  • Clinical outcomes research

Background:

  • Limited data links Car Seat Tolerance Screen (CSTS) results to adverse outcomes in preterm and low birth weight (LBW) neonates.
  • The CSTS is widely used, but its long-term predictive value for post-discharge health is not well-established.

Purpose of the Study:

  • To determine the longer-term post-discharge outcomes of infants who failed an initial CSTS.
  • To investigate if CSTS failure is associated with increased morbidity in later childhood.

Main Methods:

  • A case-control study matched infants who failed CSTS (cases) with those who passed (controls) based on sex, gestational age, and birth weight.
  • Data was collected via retrospective medical record review and parental surveys 2-3 years post-discharge.
  • Bivariate analysis compared clinical and demographic risk factors between failed and passed CSTS groups.

Main Results:

  • Infants who failed CSTS were significantly more likely to be diagnosed with obstructive sleep apnea (OSA) and asthma.
  • A higher incidence of albuterol treatment was observed in the failed CSTS group.
  • No significant differences were found in urgent care visits or hospital admissions between groups, though developmental delays were more frequent in cases.

Conclusions:

  • This study is the first to assess long-term post-discharge outcomes following CSTS.
  • Failure to pass the CSTS is associated with a significantly increased incidence of respiratory diagnoses, including OSA and asthma, by 2-3 years post-discharge.
  • CSTS may serve as a valuable tool for identifying neonates at higher risk for subsequent respiratory and developmental issues.
Abstract

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