OXYGEN DESATURATION OF SELECTED TERM INFANTS IN CAR SEATS

Objectives. Premature infants are known to be at risk for oxygen (O-2) desaturation and/or apnea in car seats. Since 1990, the American Acad emy 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 O-2 desaturation, apnea, or bradycardia while in an infant car seat. Methods. Metro West Medical Center is a community hos pital with a level II neonatal unit. Term infants who in the judgment of their pediatrician were felt to be at risk for O-2 desaturation or apnea were monitored for a 90-minute period in a ear seat and observed for transcutaneous O-2 desaturation, apnea, or bradycardia. In additi on, 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 O-2 des aturation <90%. In addition, five of 28 monitored infants (17.8%) had borderline results (O-2 saturation, 90 to 93%). All four infants monit ored because of genetic syndromes had abnormal results. O-2 desaturati on was also observed in two term infants who had been observed to be a pneic by a parent after discharge from the nursery. Conclusions. In se lected circumstances (eg, genetic disorders or observed apnea) term in fants may be at risk for O-2 desaturation in an upright car seat and m onitoring these infants in car seats before nursery discharge should b e considered. Because not all infants at risk for O-2 desaturation can be identified at birth, an alternative approach would be to recommend , unless medically contraindicated leg, gastroesphogeal reflux when su pine), that infants should routinely be transported in a supine positi on car seat in the early months of life.