78: Factors Predicting Car Seat Test Failure in Late Preterm Infants (LPI): A Retrospective Chart Review

Smith, RW; Mohamed, Adel; Young, Julia M.; Jefferies, Ann L; Shah, V

doi:10.1093/pch/19.6.e35-76

Cited by 5 publications

(9 citation statements)

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“…Smith et al also found multiple gestation to be a significant predictor of CSTS failure on univariate and multivariable modeling in their study of late preterm infants. 5 Though they were not able to explain this finding, they did note that mean weight at the time of testing was lower in multiples who failed when compared with singletons who failed, though this was not significant in their predictive model. We did not find that weight at the time of testing was significantly lower in multiples.…”

Section: Discussionmentioning

confidence: 89%

Assessment of Anthropometric Measurements as Predictors of Car Seat Screening Failure

et al. 2017

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Objective The objective of this study was to determine whether anthropometric measurements such as head circumference (HC), body mass index (BMI), and body surface area (BSA) can predict car seat tolerance screen (CSTS) failure. We hypothesized that subjects with larger HC and lower BMI/BSA would have increased risk of failure. Study Design We performed retrospective medical record review of infants born in 2013 who qualified for CSTS due to being born preterm (< 37 weeks) or low birth weight (LBW). We performed bivariate analyses of clinical and demographic risk factors including anthropometrics to identify predictors of CSTS failure. Results In this study, 19 of 366 subjects failed their CSTS (5.3%). There were no significant differences in HC, length, BSA, BMI, or ratio of HC to length, BMI, or BSA between those who passed versus failed. On subgroup analysis of preterm infants, the significant predictor of failure was multiple gestation (p = 0.024). In the term LBW cohort, requiring nasal canula (NC) (p = 0.03) and having limited or no prenatal care (PNC) (p = 0.0006) were both significant predictors of failure. Conclusion Neither absolute measurements nor the ratios of HC to body measurements predicted CSTS outcome. Multiple gestation was a significant predictor of failure in preterm infants, while NC requirement and poor PNC were predictors in LBW term infants.

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Section: Discussionmentioning

confidence: 89%

Assessment of Anthropometric Measurements as Predictors of Car Seat Screening Failure

et al. 2017

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“…33 Our rate for car seat test (CST) failure in the FCC in the pre-LBB cohort was 6.1%, compared to 14.5% in the LBB cohort, consistent with the existing literature that shows a 4 to 26% failure rate in the LPI population. [41][42][43][44] While the difference between the two groups did not reach statistical significance, the discrepancy may still represent a marker for fragility in the LPI. Although all LPI may not need full resuscitative efforts immediately after they are born, there may be infants that benefit from the cardiorespiratory monitoring even as they near discharge.…”

Section: Transfersmentioning

confidence: 85%

Short-Term Outcomes following Standardized Admission of Late Preterm Infants to Family-Centered Care

et al. 2019

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Objective The study compares the short-term outcomes of late preterm infants (LPI) at an academic center in San Diego, California after a change in protocol that eliminated a previously mandatory 12-hour neonatal intensive care unit (NICU) observation period after birth. Study Design This is a retrospective observational study examining all LPI born with gestational age 35 to 366/7 weeks between October 1, 2016 and October 31, 2017. A total of 189 infants were included in the review. Short-term outcomes were analyzed before and after the protocol change. Results Transfers to the NICU from family-centered care (FCC) were considerably higher (23.2%) following the protocol change, compared to before (8.2%). More infants were transferred to the NICU for failed car seat tests postprotocol compared to preprotocol. Length of stay before the protocol change was 5.13 days compared to 4.80 days after. Conclusion LPI are vulnerable to morbidities after delivery and through discharge. We found an increase in failed car seat tests in LPI cared for in FCC after elimination of a mandatory NICU observation after birth. The transitions of care from delivery to discharge are key checkpoints in minimizing complications.

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“…8 Researchers in a subsequent study found a 26% failure rate in their latepreterm population but noted that .25% of eligible subjects were transferred to a higher level of care before the CSTS, limiting the ability to interpret the data. 9 In both studies, a majority of CSTS failures were in those deemed healthy enough to be admitted to the newborn nursery (NBN). 8,9 Both studies noted that a substantial percentage (35%-55%) of late-preterm infants who failed a CSTS continued to have cardiorespiratory instability, resulting in transfer to the NICU for a higher level of care.…”

Section: Resultsmentioning

confidence: 99%

“…9 In both studies, a majority of CSTS failures were in those deemed healthy enough to be admitted to the newborn nursery (NBN). 8,9 Both studies noted that a substantial percentage (35%-55%) of late-preterm infants who failed a CSTS continued to have cardiorespiratory instability, resulting in transfer to the NICU for a higher level of care. Clearly, more information is needed to help guide providers when it comes to CSTSs in this population.…”

Section: Resultsmentioning

confidence: 99%

Car Seat Tolerance Screening for Late-Preterm Infants

2020

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78: Factors Predicting Car Seat Test Failure in Late Preterm Infants (LPI): A Retrospective Chart Review

Cited by 5 publications

References 0 publications

Assessment of Anthropometric Measurements as Predictors of Car Seat Screening Failure

Assessment of Anthropometric Measurements as Predictors of Car Seat Screening Failure

Short-Term Outcomes following Standardized Admission of Late Preterm Infants to Family-Centered Care

Car Seat Tolerance Screening for Late-Preterm Infants

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