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Significance of Grunting Respirations in Infants Admitted to a Well-Baby Nursery
Gentry C. Yost, MD;
Paul C. Young, MD;
Karen F. Buchi, MD
Arch Pediatr Adolesc Med. 2001;155:372-375.
Objectives (1) To determine the frequency and duration of grunting in term and
near-term newborns; (2) to determine the peripartum characteristics associated
with grunting; and (3) to compare the short-term outcomes of newborns with
and without grunting.
Design Medical record review of all newborns admitted to a well-baby nursery
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 newborn clinical characteristics,
clinical course, and length of stay.
Results Grunting respirations beginning during the first 4 hours of life were
recorded for 81 (17.4%) of 466 newborns. Fifty-five (68%) stopped grunting
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 mothers
of nongrunters (33% vs 20%; P = .03). More grunting
infants than nongrunters received bag and mask resuscitation (15% vs 5%; P = .01). More chest radiographs, 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 neonatal 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 hours to
give the newborn a chance to stop grunting or show other signs of respiratory
illness.
From the Departments of Pediatrics, University of California, Fresno
(Dr Yost), and University of Utah, Salt Lake City (Drs Young and Buchi).
Corresponding author and reprints: Karen F. Buchi, MD, Department
of Pediatrics, University of Utah, 50 N Medical Dr, Salt Lake City, UT 84132
(e-mail: karen.buchi{at}hsc.utah.edu).
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
Grunting Respirations in Newborns
JWatch General 2001;2001:5-5.
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