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Discontinuation of Car Seat Tolerance Screening and Postdischarge Adverse Outcomes in Infants Born Preterm

David Braun1, Joseph W Kaempf2, Ngoc J Ho3

  • 1Department of Neonatal-Perinatal Medicine, Southern California Permanente Medical Group, Pasadena, CA; Department of Research and Evaluation, Southern California Permanente Medical Group, Pasadena, CA.

The Journal of Pediatrics
|June 23, 2023
PubMed

Insights

Discontinuing car seat tolerance screening (CSTS) for preterm infants did not increase 30-day postdischarge adverse outcomes. Further evaluation is needed to determine the value of CSTS as a standard assessment.

Area of Science:

  • Neonatology
  • Pediatric Health Outcomes
  • Health Services Research

Background:

  • Car seat tolerance screening (CSTS) is a predischarge assessment for preterm infants.
  • The clinical utility and impact of discontinuing CSTS on infant safety after discharge require investigation.

Purpose of the Study:

  • To examine the association between discontinuing predischarge car seat tolerance screening (CSTS) and 30-day postdischarge adverse outcomes in preterm infants.

Main Methods:

  • A retrospective cohort study was conducted in a 14-hospital integrated health care system.
  • Infants born preterm between 2010-2021 were analyzed, comparing outcomes during periods with and without CSTS.
  • The primary outcome was a composite of death, 911 call-triggered transports, or readmissions for specific respiratory and cardiorespiratory events within 30 days of discharge.

Main Results:

  • The unadjusted primary outcome rate was 1.02% with CSTS and 1.06% after discontinuation (P=.76).
  • Adjusted odds ratio was 0.95 (95% CI: 0.75-1.19), indicating no significant difference.
  • No statistically significant differences were observed in outcome components, gestational age strata, or NICU admission status.

Conclusions:

  • Discontinuation of CSTS in a large health care network was not linked to increased 30-day postdischarge adverse events in preterm infants.
  • The findings suggest that CSTS may not be essential for all preterm infants before discharge.
  • Further research is warranted to evaluate the ongoing value of CSTS as a standard predischarge assessment.
Abstract

Keywords:
car seat testcar seat tolerance screendischarge readinessinfants born preterm

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