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The American Academy of Pediatrics recommends predischarge car seat tolerance screening (CSTS) for preterm and low-birthweight, full-term newborns to identify cardiorespiratory instability in a semi-upright position. However, some centers have discontinued the practice, citing limited supporting evidence. In this systematic review and meta-analysis, the authors evaluated postdischarge outcomes among infants who underwent CSTS and in those who did not, excluding studies involving comorbidities beyond prematurity and low birth weight. They found no randomized clinical trials. Of 21 included studies, 3 were nonrandomized interventional trials with a pooled sample of 54,000 infants (including 27,800 without CSTS); most of the studies inv…