Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Test−retest reliability of the infant car-seat challenge

Journal of Perinatology volume 34, pages 54–58 (2014)Cite this article

Subjects

Abstract

Objective:

To evaluate how a single infant car-seat challenge (ICSC) predicts subsequent respiratory physiology in premature infants.

Study Design:

Prospective observational study of infants born at <37 weeks gestational age. Subjects underwent three ICSCs and we evaluated clinical characteristics, pass rate, and predictive value of a single ICSC pass.

Result:

Completed three ICSCs on 60 subjects. Seven failed initial ICSC (11.7%). Those who failed had lower birth weights. Of the 53 that initially passed, 47 passed two subsequent tests (89%). Those who passed an initial test and failed a subsequent test had lower weights at each ICSC.

Conclusion:

Our results indicate that passing an ICSC is highly predictive of passing subsequent ICSCs. Lower weights at birth and at the time of ICSC were associated with increased risk of failure. We recommend including low birth weight as an inclusion criterion for ICSCs.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1

Similar content being viewed by others

References

  1. Willett LD, Leuschen MP, Nelson LS, Nelson Jr. RM . Risk of hypoventilation in premature infants in car seats. J Pediatr 1986; 109 (2): 245–248.

    Article  CAS  Google Scholar 

  2. Willett LD, Leuschen MP, Nelson LS, Nelson RM Jr. . Ventilatory changes in convalescent infants positioned in car seats. J Pediatr 1989; 115 (3): 451–455.

    Article  CAS  Google Scholar 

  3. Bull MJ, Stroup KB . Premature infants in car seats. Pediatrics 1985; 75 (2): 336–339.

    CAS  PubMed  Google Scholar 

  4. American Academy of Pediatrics Committee on Accident and Poison Prevention. Safe transportation of newborns discharged from the hospital. Pediatrics 1990; 86 (3): 486–487.

    Google Scholar 

  5. American Academy of Pediatrics Committee on Injury and Poison Prevention and Committee on Fetus and Newborn. Safe transportation of premature infants. Pediatrics 1991; 87 (1): 120–122.

    Google Scholar 

  6. Safe transportation of premature and low birth weight infants. American Academy of Pediatrics. Committee on Injury and Poison Prevention and Committee on Fetus and Newborn. Pediatrics 1996; 97 (5): 758–760.

    Google Scholar 

  7. Bull M, Agran P, Laraque D, Pollack SH, Smith GA, Spivak HR et al. American Academy of Pediatrics. Committee on Injury and Poison Prevention. Safe transportation of newborns at hospital discharge. Pediatrics 1999; 104 (4 Pt 1): 986–987.

    CAS  PubMed  Google Scholar 

  8. Bull MJ, Engle WA . Safe transportation of preterm and low birth weight infants at hospital discharge. Pediatrics 2009; 123 (5): 1424–1429.

    Article  Google Scholar 

  9. US Department of Labor BoLS 2011 Available from http://www.bls.gov/oes/current/oes291111.htm (cited 7 September 2012).

  10. Williams LE, Martin JE . Car seat challenges: where are we in implementation of these programs? J Perinat Neonatal Nurs 2003; 17 (2): 158–163.

    Article  Google Scholar 

  11. DeGrazia M . Stability of the infant car seat challenge and risk factors for oxygen desaturation events. J Obstet Gynecol Neonatal Nurs 2007; 36 (4): 300–307.

    Article  Google Scholar 

  12. Fenton TR, Kim JH . A systematic review and meta-analysis to revise the Fenton growth chart for preterm infants. BMC Pediatr 2013; 13: 59–71.

    Article  Google Scholar 

  13. 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 (6): F468–F472.

    Article  Google Scholar 

  14. Schutzman DL, Salvador A, Janeczko M, Weisberg L, Tran N, Porat R . A comparison of the infant car seat challenge and the polysomnogram at the time of hospital discharge. Arch Dis Child Fetal Neonatal Ed 2013; 98: F411–F415.

    Article  Google Scholar 

  15. Jadcherla SR, Wang M, Vijayapal AS, Leuthner SR . Impact of prematurity and co-morbidities on feeding milestones in neonates: a retrospective study. J Perinatol 2010; 30 (3): 201–208.

    Article  CAS  Google Scholar 

  16. Salhab WA, Khattak A, Tyson JE, Crandell S, Sumner J, Goodman B et al. Car seat or car bed for very low birth weight infants at discharge home. J Pediatr 2007; 150 (3): 224–228.

    Article  Google Scholar 

  17. Thach BT, Stark AR . Spontaneous neck flexion and airway obstruction during apneic spells in preterm infants. J Pediatr 1979; 94 (2): 275–281.

    Article  CAS  Google Scholar 

  18. Stark AR, Thach BT . Mechanisms of airway obstruction leading to apnea in newborn infants. J Pediatr 1976; 89 (6): 982–985.

    Article  CAS  Google Scholar 

  19. Taylor B Guidelines for Evaluating and Expressing the Uncertainty of National Institute of Standards and Technology (NIST) Measurement Results. Commerce USDo, 1994.

  20. Davis NL, Zenchenko Y, Lever A, Rhein L . Car seat safety for preterm noenates: implementation and testing parameters of the infant car seat challenge. Acad Pediatr 2013; 13 (3): 272–277.

    Article  Google Scholar 

  21. Ramanathan R, Corwin MJ, Hunt CE, Lister G, Tinsley LR, Baird T et al. Cardiorespiratory events recorded on home monitors: comparison of healthy infants with those at increased risk for SIDS. JAMA 2001; 285 (17): 2199–2207.

    Article  CAS  Google Scholar 

  22. Naulaers G, Daniels H, Allegaert K, Rayyan M, Debeer A, Devlieger H . Cardiorespiratory events recorded on home monitors: the effect of prematurity on later serious events. Acta Paediatr 2007; 96 (2): 195–198.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

We thank the NICU nurses at Beth Israel Deaconess Medical Center in Boston, MA, for their assistance in the completion of this study, the Dorel Juvenile Group (Columbus, IN) for providing car-seat equipment for this study, the Harvard Neonatal-Perinatal Fellowship Program and the Scholars in Clinical Science Program for their support of Dr Davis. No external funding was secured for this study including from the Dorel Juvenile Group. We have no financial relationships relevant to this article to disclose. Dorel Juvenile Group had no input at any time in the design and conduct of the study; collection, management, analysis, and interpretation of the data; or preparation, review, or approval of the manuscript.

Author information

Authors and Affiliations

  1. Division of Neonatology, University of Maryland Hospital for Children, Baltimore, MD, USA

    N L Davis

  2. Division of Newborn Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA

    M L Gregory

  3. Division of Respiratory Diseases, Boston Children’s Hospital, Boston, MA, USA

    L Rhein

  4. Division of Newborn Medicine, Boston Children’s Hospital, Boston, MA, USA

    L Rhein

Authors
  1. N L Davis
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M L Gregory
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. L Rhein
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to N L Davis.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Davis, N., Gregory, M. & Rhein, L. Test−retest reliability of the infant car-seat challenge. J Perinatol 34, 54–58 (2014). https://doi.org/10.1038/jp.2013.118

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/jp.2013.118

Keywords

This article is cited by

Search

Advanced search

Quick links