Oxygen desaturation of selected term infants in car seats.
OBJECTIVE
Premature infants are known to be at risk for oxygen (O2) desaturation and/or apnea in car seats. Since 1990, the American Academy of Pediatrics has recommended a period of monitoring in car seats before hospital discharge for infants born at < 37 weeks gestation. The objective of this report is to determine if selected term infants are also at risk for O2 desaturation, apnea, or bradycardia while in an infant car seat.


METHODS
MetroWest Medical Center is a community hospital with a level II neonatal unit. Term infants who in the judgment of their pediatrician were felt to be at risk for O2 desaturation or apnea were monitored for a 90-minute period in a car seat and observed for transcutaneous O2 desaturation, apnea, or bradycardia. In addition, several infants who were admitted to the pediatric inpatient unit after discharge from the nursery were monitored in a similar fashion.


RESULTS
Eight of 28 monitored infants (28.6%) had a period of O2 desaturation < 90%. In addition, five of 28 monitored infants (17.8%) had borderline results (O2 saturation, 90 to 93%). All four infants monitored because of genetic syndromes had abnormal results. O2 desaturation was also observed in two term infants who had been observed to be apneic by a parent after discharge from the nursery.


CONCLUSIONS
In selected circumstances (eg, genetic disorders or observed apnea) term infants may be at risk for O2 desaturation in an upright car seat and monitoring these infants in car seats before nursery discharge should be considered. Because not all infants at risk for O2 desaturation can be identified at birth, an alternative approach would be to recommend, unless medically contraindicated (eg, gastroesphogeal reflux when supine), that infants should routinely be transported in a supine position car seat in the early months of life.
Bass
J L
JL
Department of Pediatrics, MetroWest Medical Center, Framingham, MA 01701, USA.
Mehta
K A
KA
D001049:Apnea / Q000097:blood / Q000175:diagnosis; D001785:Blood Gas Monitoring, Transcutaneous; D001919:Bradycardia / Q000097:blood / Q000175:diagnosis; D003635:De Lange Syndrome / Q000097:blood; D005764:Gastroesophageal Reflux / Q000097:blood; D006801:Humans; D000860:Hypoxia / Q000097:blood / Q000175:diagnosis*; D015370:Infant Equipment; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008297:Male; D008404:Massachusetts; D010100:Oxygen / Q000097:blood*; D011674:Pulse; D012119:Respiration; D012307:Risk Factors
D010100:Oxygen