Objectives: (1) To determine the frequency and duration of grunting in term
and near-term newborns; (2) to determine the peripartum characteristics as
sociated with grunting; and (3) to compare the short-term outcomes of newbo
rns with and without grunting.
Design: Medical record review of all newborns admitted to a well-baby nurse
ry during a 2-month period.
Setting: University well-baby nursery for term infants, with more than 2700
deliveries annually.
Main Outcome Measures: Frequency and duration of grunting, maternal and new
born clinical characteristics, clinical course, and length of stay.
Results: Grunting respirations beginning during the first 4 hours of life w
ere recorded for 81 (17.4%) of 466 newborns. Fifty-five (68%) stopped grunt
ing 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 mo
thers of nongrunters (33% vs 20%; P=.03), More grunting infants than nongru
nters received bag and mask resuscitation (15% vs 5%; P=.01). More chest ra
diographs, 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 neona
tal 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 h
ours to give the newborn a chance to stop grunting or show other signs of r
espiratory illness.