The prevalence of congenital heart disease in newborn detected by pulse oximeter screening test at 24 hours of birth and its correlation with clinical findings and ECHO

Vindhya Suresh; Savitha Mysore Ramraj

doi:10.18203/2349-3291.ijcp20241675

Authors

Vindhya Suresh Department of Paediatrics, Mysore Medical College and Research Institute, Mysore, Karnataka, India
Savitha Mysore Ramraj Department of Paediatrics, Mysore Medical College and Research Institute, Mysore, Karnataka, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20241675

Keywords:

Clinical examination, Congenital heart disease, Echocardiography, Pulse oximeter screening

Abstract

Background: Detecting congenital heart disease (CHD) early is crucial for better outcomes, but most newborns show no symptoms. Newborn screening for CHD can identify such cases preventing serious consequences. This study aims to determine CHD prevalence and evaluate the effectiveness of pulse oximeter screening and clinical examination, correlating them with echocardiography findings.

Methods: A cross-sectional study was conducted to screen for CHD in all newborns born in our institution over a period of 3 months. A sample of 660 newborns were screened by pulse oximeter screening and clinical examination after random sampling.

Results: Comparison of baseline data like age distribution in mothers, gender and gestational age were comparable between newborns with CHD and those without CHD. A total of 8 CHDs were picked up after screening 660 newborns screened during a period of 3 months. CHDs that were picked up included hypoplastic left heart syndrome, pulmonary atresia, bicuspid aortic valve, transposition of great arteries, coarctation of the aorta, and other complex CHDs. It was found that either clinical examination or pulse oximeter screening has higher sensitivity than pulse oximetry screening or clinical examination alone.

Conclusions: For identification of a CHD in newborns after 24 hours of birth the order of preference for screening based on sensitivity is as follows-either pulse oximeter screening or clinical examination >clinical examination >pulse oximeter screening >pulse oximeter screening and clinical examination.

Metrics

Metrics Loading ...

References

Centre for Disease Control and Presentation. Congenital heart disease. Available at: https://www.cdc.gov/ncbddd/heartdefects/index.html. Accessed on 5 May 2024.

Jullien S. Newborn pulse oximetry screening for critical congenital heart defects. BMC Pediatr. 2021;21(1):305.

Saxena A. Congenital heart disease in India: A status report. Indian Pediatr. 2018;55(12):1075-82.

Engel MS, Kochilas LK. Pulse oximetry screening: A review of diagnosing critical congenital heart disease in newborns. Med Devices. 2016;9:199-203.

Singh Y, Chen SE. Impact of pulse oximetry screening to detect congenital heart defects: 5 years experience in a UK regional neonatal unit. Eur J Pediatr. 2022;181(2):813-21.

Smitha R. Prevalence of congenital heart diseases in Mysore. Indian J Human Genetics. 2006;12(1):11-6.

Narayen IC, Te Pas AB, Blom NA, van den Akker-van Marle ME. Cost-effectiveness analysis of pulse oximetry screening for critical congenital heart defects following homebirth and early discharge. Eur J Pediatr. 2019;178(1):97-103.

Engel MS, Kochilas LK. Pulse oximetry screening: A review of diagnosing critical congenital heart disease in newborns. Med Devices. 2016;9:199-203.

Martin GR, Ewer AK. Updated strategies for pulse oximetry screening for critical congenital heart disease. Pediatrics. 2020;146(1):e20191650.

Harold JG. Cardiology patient page: Screening for critical congenital heart disease in newborns. Circulation. 2014;130(9):e79-e81.

Kliegman RM, St. Geme J. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier. 2019.

Breinholt JP. Cardiac disorders. In: Eichenwald EC, Hansen AR, Martin CR, Stark AR (eds.), Cloherty and Stark’s Manual of neonatal care. 7th ed. New Delhi, India: Wolters Kluwer. 2021;534.

Yales RWM. Cardiovascular disease. Chapter 28. In: Rennie JM, Roberton NRC (eds.), Rennie and Robertson’s Textbook of Neonatology. 5th ed. Edinburgh: Churchill Livingstone Elsevier. 2021;613.

Baldwin HS, Dees E. Cardiovascular system. Chapter 50. In: Gleason CA, Juul SE (eds.), Avery’s Diseases of the newborn. 10th ed. Philadelphia, PA: Elsevier. 2018;698.

Agarwal R, Deorari A, Paul VK. AIIMS Protocols in neonatology: Approach to a newborn with suspected congenital heart disease. 2nd ed. India: Noble Vision Publishers. 2019;150.

Mahle WT, Newburger JW, Matherne GP, Smith FC, Hoke TR, Koppel R, et al. Role of pulse oximetry in examining newborns for congenital heart disease: A scientific statement from the American Heart Association and American Academy of Pediatrics. Circulation. 2009;120(5):447-58.

Thangaratinam S, Brown K, Zamora J, Khan KS, Ewer AK. Pulse oximetry screening for critical congenital heart defects in asymptomatic newborn babies: A systematic review and meta-analysis. Lancet. 2012;379(9835):2459-64.

Ewer AK. Pulse oximetry screening for critical congenital heart defects in newborn infants: Should it be routine Arch Dis Child Fetal Neonatal Ed. 2014;99(1):F93-5.