Download PDF
Am J Perinatol 2017; 34(13): 1318-1325
DOI: 10.1055/s-0037-1603506
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Assessment of Anthropometric Measurements as Predictors of Car Seat Screening Failure

Natalie L. Davis
1   University of Maryland School of Medicine, Baltimore, Maryland
,
Elena Donald
1   University of Maryland School of Medicine, Baltimore, Maryland
,
Maura Heffernan
1   University of Maryland School of Medicine, Baltimore, Maryland
,
Brian N. Corwell
1   University of Maryland School of Medicine, Baltimore, Maryland
› Author Affiliations
Further Information

Publication History

30 March 2017

21 April 2017

Publication Date:
22 May 2017 (online)

    Permissions and Reprints

Abstract

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.

Keywords

car seat tolerance screen - car seat test - infant car seat challenge - prematurity - apnea

Funding

Ms. Donald and Ms. Heffernan were awarded a stipend from the Proposed Research Initiated by Students and Mentors (PRISM) Program from the University of Maryland School of Medicine to participate in this research project. No additional funding for this article was received.


 

  • References

  • 1 Bull MJ, Engle WA. ; Committee on Injury, Violence, and Poison Prevention and Committee on Fetus and Newborn; American Academy of Pediatrics. Safe transportation of preterm and low birth weight infants at hospital discharge. Pediatrics 2009; 123 (05) 1424-1429
    CrossrefPubMedGoogle Scholar
  • 2 Davis NL, Zenchenko Y, Lever A, Rhein L. Car seat safety for preterm neonates: implementation and testing parameters of the infant car seat challenge. Acad Pediatr 2013; 13 (03) 272-277
    CrossrefPubMedGoogle Scholar
  • 3 Davis NL, Condon F, Rhein LM. Epidemiology and predictors of failure of the infant car seat challenge. Pediatrics 2013; 131 (05) 951-957
    CrossrefPubMedGoogle Scholar
  • 4 Davis NL. Car seat screening for low birth weight term neonates. Pediatrics 2015; 136 (01) 89-96
    CrossrefPubMedGoogle Scholar
  • 5 Smith RW, Mohamed A, Young J, Jefferies A, Shah V. Factors associated with car seat test failure in late preterm infants: a retrospective chart review. Paediatr Child Health 2016; 21 (01) 16-20
    PubMedGoogle Scholar
  • 6 Elder DE, Russell L, Sheppard D, Purdie GL, Campbell AJ. Car seat test for preterm infants: comparison with polysomnography. Arch Dis Child Fetal Neonatal Ed 2007; 92 (06) F468-F472
    CrossrefPubMedGoogle Scholar
  • 7 Bull MJ, Stroup KB. Premature infants in car seats. Pediatrics 1985; 75 (02) 336-339
    PubMedGoogle Scholar
  • 8 Merchant JR, Worwa C, Porter S, Coleman JM, deRegnier RA. Respiratory instability of term and near-term healthy newborn infants in car safety seats. Pediatrics 2001; 108 (03) 647-652
    CrossrefPubMedGoogle Scholar
  • 9 Hoffman BD, Gallardo AR, Carlson KF. Unsafe from the start: serious misuse of car safety seats at newborn discharge. J Pediatr 2016; 171: 48-54
    CrossrefPubMedGoogle Scholar
  • 10 Carlo WA, Beoglos A, Siner BS, Martin RJ. Neck and body position effects on pulmonary mechanics in infants. Pediatrics 1989; 84 (04) 670-674
    PubMedGoogle Scholar
  • 11 Tonkin SL, McIntosh CG, Hadden W, Dakin C, Rowley S, Gunn AJ. Simple car seat insert to prevent upper airway narrowing in preterm infants: a pilot study. Pediatrics 2003; 112 (04) 907-913
    CrossrefPubMedGoogle Scholar
  • 12 Burdi AR, Huelke DF, Snyder RG, Lowrey GH. Infants and children in the adult world of automobile safety design: pediatric and anatomical considerations for design of child restraints. J Biomech 1969; 2 (03) 267-280
    CrossrefPubMedGoogle Scholar
  • 13 Haycock GB, Schwartz GJ, Wisotsky DH. Geometric method for measuring body surface area: a height-weight formula validated in infants, children, and adults. J Pediatr 1978; 93 (01) 62-66
    CrossrefPubMedGoogle Scholar
  • 14 Brion L, Fleischman AR, Schwartz GJ. Evaluation of four length-weight formulas for estimating body surface area in newborn infants. J Pediatr 1985; 107 (05) 801-803
    CrossrefPubMedGoogle Scholar
  • 15 McIntosh CG, Tonkin SL, Gunn AJ. Randomized controlled trial of a car safety seat insert to reduce hypoxia in term infants. Pediatrics 2013; 132 (02) 326-331
    CrossrefPubMedGoogle Scholar
  • 16 Davis NL. Screening for cardiopulmonary events in neonates: a review of the infant car seat challenge. J Perinatol 2015; 35 (04) 235-240
    CrossrefPubMedGoogle Scholar