Screening identifies cases of newborn congenital heart defects missed by antenatal ultrasonography
FRIDAY, Aug. 5 (HealthDay News) -- Pulse oximetry is a reasonably accurate screening test for detecting congenital heart defects in newborns, according to a study published online Aug. 5 in The Lancet.
Andrew K. Ewer, M.D., from the University of Birmingham in the United Kingdom, and colleagues investigated the accuracy of pulse oximetry as a screening test for congenital heart defects. A total of 20,055 newborn babies born after more than 34 weeks of gestation were screened with pulse oximetry before discharge. Echocardiography was performed on babies who did not achieve predetermined oxygen saturation thresholds; all others were followed up to 12 months of age by registries and clinic visits. Sensitivity and specificity of pulse oximetry for detection of critical congenital heart defects or major congenital heart disease were the main outcome measures.
The investigators identified 53 newborn babies with major congenital heart disease, including 24 critical cases, a prevalence of 2.6 per 1,000 live births. The sensitivity of pulse oximetry was 75.00 and 49.06 percent for critical cases and all major congenital heart defects, respectively. Prior antenatal ultrasonography indicated 35 suspected congenital heart defects, the exclusion of which reduced the sensitivity to 58.33 percent for critical cases and to 28.57 percent for all major congenital heart defects. A total of 169 babies showed false positive results, out of which, six had significant but not major congenital heart defects, while 40 had other illnesses that required urgent medical intervention.
"Pulse oximetry is a safe, non-invasive, feasible, and reasonably accurate test, which has a sensitivity that is better than that of antenatal screening and clinical examination," the authors write.
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