Car Seat or Car Bed for Very Low Birth Weight Infants at Discharge Home

Objective

To compare the incidence of apnea, bradycardia, or desaturation in a car seat with that in a car bed for preterm very low birth weight (≤1500 g) infants.

Study design

Infants were studied for 120 minutes in a car seat and in a car bed. Apnea (>20 seconds), bradycardia (heart rate <80/min for >5 seconds), desaturation (Spo₂ <88% for >10 seconds), and absent nasal flow were monitored.

Results

We assessed 151 infants (median birth weight, 1120 g [range, 437 to 3105)]; median birth gestational age, 29 weeks [24 to 34]) in both devices. Twenty-three infants (15%) had ≥1 event in the car seat compared with 29 (19%) in the car bed (P = .4). Time to first event was similar in the car seat and car bed (mean, 54 to 55 minutes). In logistic regression analyses, bronchopulmonary dysplasia was a significant predictor for a car seat event and a lower gestational age at birth was a risk factor for a car bed event.

Conclusions

We found no evidence that an event is less likely in a car bed than in a car seat. Whichever device is used, very low birth weight infants require observation during travel.

Abbreviations: BPD, Bronchopulmonary dysplasia, GA, Gestational age, VLBW, Very low birth weight