Association between oxygen saturation and critical congenital heart disease in newborns

Abstract

Background Critical congenital heart disease (CCHD) is relatively common, with a prevalence of 6-8 in every 1,000 live births. This congenital anomaly is a newborn condition that would be ideally suited for a screening program, if simple and reliable methods were available. Pulse oximetry (PO) has been proposed as a screening method to detect CCHD.
 Objective To assess for a possible association between decreased oxygen saturation and CCHD in newborns.
 Methods We conducted a cross-sectional study from March 2014 to February 2015 in several hospitals in North Sumatra. Healthy, full term and post-term newborns aged 2 to 72 hours underwent pulse oximetry measurements on the right hand and one of the lower extremities. If oxygen saturation (SpO2) was ≤ 95%, the measurement was repeated 2 more times. Subjects also underwent echocardiography.
 Results A total of 386 newborns underwent SpO2 measurements: 377 newborns had SpO2 > 95% and 9 newborns had SpO2 ≤ 95%. Of the infants with SpO2 > 95%, 297 were excluded because their parents refused echocardiography examination. Thus, 80 newborns with SpO2 > 95% and 9 newborns with SpO2 ≤ 95% underwent echocardiography. Echocardiography revealed that 5 of 9 newborns with SpO2 ≤ 95% suffered from Tetralogy of Fallot (ToF) (3 subjects) and transposition of the great arteries (TGA) (2 subjects). One infant with SpO2 > 95% had ventricular septal defect (VSD), as detected by echocardiography. Oxygen saturation ≤ 95% had significant association with CCHD (P<0.001).
 Conclusion Decreased oxygen saturation has a significant association with critical congenital heart disease in newborns.

Early versus late diagnosis of critical congenital heart disease at Sanglah Hospital Denpasar, Bali

“…Among children with early detection of CCHD, Tetralogy of Fallot, pulmonary atresia and transposition of great arteries were the most widely found. This study was in line with study in North Sumatra in which the most common CCHD found in early detection were Tetralogy of Fallot and transposition of great arteries [18]. Tetralogy of Fallot is the most common cyanotic heart condition in children, with estimated prevalence 1 in 3,500 to 1 in 4,300 people followed by transposition of great arteries and hypoplastic left heart syndrome [19].…”