Significance of grunting respirations in infants admitted to a well-baby nursery.
OBJECTIVE
(1) To determine the frequency and duration of grunting in term and near-term newborns; (2) to determine the peripartum characteristics associated with grunting; and (3) to compare the short-term outcomes of newborns with and without grunting.


METHODS
Medical record review of all newborns admitted to a well-baby nursery during a 2-month period.


METHODS
University well-baby nursery for term infants, with more than 2700 deliveries annually.


METHODS
Frequency and duration of grunting, maternal and newborn clinical characteristics, clinical course, and length of stay.


RESULTS
Grunting respirations beginning during the first 4 hours of life were recorded for 81 (17.4%) of 466 newborns. Fifty-five (68%) stopped grunting within 30 minutes of birth, 69 (85%) by 1 hour, and 75 (93%) by 2 hours. More mothers of grunting infants received intrapartum antibiotics than mothers of nongrunters (33% vs 20%; P =.03). More grunting infants than nongrunters received bag and mask resuscitation (15% vs 5%; P =.01). More chest radiographs, blood cell counts, and blood cultures were ordered for grunting infants, and antibiotics were more often given to grunting than nongrunting infants (11.1% vs 4.6%; P =.04). Grunters' length of stay exceeded that of nongrunters (72 vs 55 hours; P =.01), but only 3 were transferred to a neonatal intensive care unit.


CONCLUSIONS
All grunting infants should be carefully observed, but because nearly all otherwise healthy term or near-term infants will stop grunting and have a benign course, other interventions can be postponed for 1 or 2 hours to give the newborn a chance to stop grunting or show other signs of respiratory illness.
Department of Pediatrics, University of California, Fresno, USA.
G C
GC
Yost
P C
PC
Young
K F
KF
Buchi
D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001724:Birth Weight; D002585:Cesarean Section; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D008431:Maternal-Fetal Exchange; D008499:Medical Records; D009725:Nurseries, Hospital; D011247:Pregnancy; D012135:Respiratory Sounds
D000900:Anti-Bacterial Agents