Research Reports - Infant car safety seats and risk of head injury

J Pediatr Surg. 2014 Jan;49(1):193-7

Stewart CL(1), Moscariello MA(2), Hansen KW(3), Moulton SL(4)

BACKGROUND/PURPOSE: We observed a high incidence of traumatic brain injuries
(TBI) in properly restrained infants involved in higher speed motor vehicle
crashes (MVCs). We hypothesized that car safety seats are inadequately protecting
infants from TBI.
METHODS: We retrospectively queried scene crash data from our State Department of
Transportation (2007-2011) and State Department of Public Health data (2000-2011)
regarding infants who presented to a trauma center after MVC.
RESULTS: Department of Transportation data revealed 94% of infants in MVCs were
properly restrained (782/833) with average speed of 44.6 miles/h when there was
concern for injury. Department of Public Health data showed only 67/119 (56.3%)
of infants who presented to a trauma center after MVC were properly restrained.
Properly restrained infants were 12.7 times less likely to present to a trauma
center after an MVC (OR=12.7, CI 95% 5.6-28.8, p<0.001). TBI was diagnosed in
73/119 (61.3%) infants; 42/73 (57.5%) properly restrained, and 31/73 (42.5%)
improperly/unrestrained (p=0.34). Average head abbreviated injury scale was
similar for properly restrained (3.2±0.2) and improperly/unrestrained infants
(3.5±0.2, p=0.37).
CONCLUSION: Car safety seats prevent injuries. However, TBI is similar among
properly restrained and improperly/unrestrained infants involved in higher speed
MVCs who present to a trauma center.

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