The Incubator #386 - 🟢 HOT TOPICS 2025 COVERAGE - Should We Still Perform Pre-Discharge Car Seat Tests?
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Dec 9, 2025 
Dr. Michael Narvey, a leading neonatologist and vice president of the Canadian Paediatric Society, challenges the necessity of pre-discharge car seat testing for newborns. He argues that the test fails to represent real-world scenarios and lacks substantial evidence of life-saving benefits. Drawing from decades of autopsy data, he highlights that rare car seat-related deaths stem from unsupervised asphyxiation, not from travel incidents. Narvey advocates for better car seat education and proper positioning instead of routine testing.
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Questioning The Car Seat Test's Validity
- The traditional pre-discharge car seat test lacks strong evidence linking it to improved mortality or long-term outcomes.
- Michael Narvey led Canadian efforts that questioned the test's validity and led to its abandonment in Canada in 2016.
From Rounds Complaint To National Change
- Michael Narvey recalls criticizing the test on rounds and later joining the Fetus and Newborn Committee to research it.
- His advocacy and research contributed to Canada abandoning pre-discharge car seat testing in 2016.
Origins Versus Evidence
- The car seat test originated from observations of desaturations in semi-reclined preterm infants, not randomized evidence of benefit.
- There is little data showing car seat testing saves lives from apnea or desaturation-related mortality.