Implications of Using Pulse Oximetry to Screen for Critical Congenital Heart Disease in Newborns

Critical congenital heart disease (CCHD) is a heart lesion for which neonates require early surgical intervention to survive. Without intervention, the rates of mortality and survival with significant disability are extremely high. Early diagnosis can potentially improve health outcomes in newborns with CCHD. Until recent years, no routine screening protocol existed. In the last few years, pulse oximetry screening for CCHD in newborns has been added to the list of recommended uniform screening panels and advocated by several health-care authorities. A positive screening test result warrants an echocardiogram to evaluate for CCHD. Newborn screens do not usually require parental consent. However, most of the states mandates in the United States include a statement allowing exemption from the screen on the basis of parental religious or personal beliefs.

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“…Hospitals need to have an established protocol regarding who and when to call for a positive screening. [ 10 ]…”

Section: Screening With Pulse Oximetrymentioning

confidence: 99%

Critical congenital heart disease screening

Chamsi-Pasha

Chamsi‐Pasha

2016

Avicenna J Med

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“…Clinical examinations cost $450,000, pulse oximetry costs $700,000 and echocardiography costs $5.35 million per year. The detection rates of pulse oximetry and echocardiography are the key characteristics that determine whether these procedures are cost-effective ( 18 , 19 ).…”

Section: The Chd Model: Screens and Costsmentioning

confidence: 99%

Current diagnosis and treatments for critical congenital heart defects

Zeng

Zhang

Liu

et al. 2016

Experimental and Therapeutic Medicine

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Congenital heart defects (CHD) affect approximately 7% of infants, and account for 3% of all infant deaths. CHD is most often caused by the defects associated with ductus arteriosus, which is a vessel that usually closes shortly after birth. The types of CHD include tetralogy of fallot, hypoplastic left heart syndrome, pulmonary atresia, total anomalous pulmonary venous return, transposition of great arteries, tricuspid atresia and truncus arteriosus. There are some risk factors that can increase the chance of a fetus developing CHD such as prematurity, an existing CHD in a first-degree relative, genetic syndromes, infections in utero, maternal drug consumptions and disorders. CHD is diagnosed is through different techniques including pulse oximetry, echocardiograms and physical exams. In this review, we examined the current incidence of CHD, the risk factors associated with CHD, the current methods of diagnosis and surgical options used to repair the defects.

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An Evaluation of the Addition of Critical Congenital Heart Defect Screening in Georgia Newborn Screening Procedures

Rentmeester

Pringle

Hogue

2017

Matern Child Health J

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Objectives Each year in the U.S., approximately 7200 infants are born with a critical congenital heart defect (CCHD). The Georgia Department of Public Health (DPH) mandated routine screening for CCHD starting January 2015. The current study evaluated hospital performance of the mandated CCHD screenings in Georgia. Methods Utilizing the DPH newborn screening surveillance system, data from 6 months before and after the mandate were analyzed for reports submitted and positive CCHD screening results. Chi square tests of independence were performed to examine the association between reporting of results for CCHD screening after the mandate and hospital nursery level [level I (well-baby/newborn); level II (special care); level III (neonatal intensive care unit-NICU)] and NICU submissions. Results In the 6 months following implementation, reports of the screening increased, but the DPH had not received information for approximately 40% of newborns. Hospitals with level III nurseries had poorer reporting rates compared to hospitals with level I or II nurseries. Newborn screening (NBS) cards submitted by NICUs were less likely to contain the CCHD screening results compared to cards submitted by regular Labor and Delivery units. Conclusions for Practice Further attention should focus on improving both CCHD screening and reporting of screening results within hospitals with level III nurseries and from NICUs at all hospital levels. Identifying and addressing the root of the issue, whether it be hospital compliance with CCHD screening or reporting of the results, will help to improve screening rates for all newborns, especially those most vulnerable.

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Implications of Using Pulse Oximetry to Screen for Critical Congenital Heart Disease in Newborns

Cited by 3 publications

References 26 publications

Critical congenital heart disease screening

Critical congenital heart disease screening

Current diagnosis and treatments for critical congenital heart defects

An Evaluation of the Addition of Critical Congenital Heart Defect Screening in Georgia Newborn Screening Procedures

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