{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:34:00Z","timestamp":1790728440287,"version":"4.1.0"},"reference-count":37,"publisher":"BMJ","issue":"4","funder":[{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["R24 HD042828"],"award-info":[{"award-number":["R24 HD042828"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Inj Prev"],"accepted":{"date-parts":[[2023,3,2]]},"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>In 2018, the American Academy of Pediatrics updated their car safety seat (CSS) guidelines to recommend that children ride rear-facing as long as possible, yet evidence from observational studies on rear-facing CSS effectiveness is limited. This study estimated the association between rear-facing CSS use and injuries among children aged 0\u20134 years who were involved in motor vehicle crashes (MVCs).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This study analysed data on all MVCs involving children aged 0\u20134 years reported to the Kansas Department of Transportation from 2011 to 2020. Children who were in a rear-facing CSS were compared with children who rode in a forward-facing device. Logistic regression was used to adjust for potential confounders.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In unadjusted models, rear-facing CSS use was associated with a 14% reduction in the odds of suffering any injury versus riding in a forward-facing CSS (OR 0.860, 95% CI 0.805 to 0.919). In models adjusted for potential confounders, rear-facing CSS use was associated with a 9% reduction in the odds of any injury relative to riding forward-facing (OR 0.909, 95% CI 0.840 to 0.983). These estimates were driven by children seated in the back outboard positions. Rear-facing CSS use was also negatively associated with incapacitating\/fatal injuries, but these estimates were imprecise.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Children aged 0\u20134 years are less likely to be injured in an MVC if they are restrained in a rear\u2014as opposed to forward\u2014facing CSS. These results are particularly relevant because a number of state CSS laws do not require children of any age to ride rear-facing.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/ip-2022-044815","type":"journal-article","created":{"date-parts":[[2023,3,14]],"date-time":"2023-03-14T13:25:36Z","timestamp":1678800336000},"page":"320-326","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Rear-facing child safety seat effectiveness: evidence from motor vehicle crash data"],"prefix":"10.1136","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2433-6206","authenticated-orcid":false,"given":"D Mark","family":"Anderson","sequence":"first","affiliation":[{"name":"Agricultural Economics & Economics, Montana State University, Bozeman, Montana, USA"},{"name":"National Bureau of Economic Research, Cambridge, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ridge W","family":"Peterson","sequence":"additional","affiliation":[{"name":"Agricultural Economics & Economics, Montana State University, Bozeman, Montana, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,3,14]]},"reference":[{"key":"2025092502064042000_29.4.320.1","unstructured":"Medline Plus . 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