First Day of Life Pulse Oximetry Screening to Detect Congenital Heart Defects

Received 26 September 2007; received in revised form 12 November 2007; accepted 17 December 2007. published online 07 March 2008.

Refers to article:

Physical Examination and Pulse Oximetry in Newborn Infants: Out with the Old, in with the New?
William T. Mahle
The Journal of Pediatrics
June 2008 (Vol. 152, Issue 6, Pages 747-748)
Full Text | Full-Text PDF (63 KB)

Accuracy of Pulse Oximetry Measurement of Heart Rate of Newborn Infants in the Delivery Room , 07 March 2008
C. Omar F. Kamlin, Jennifer A. Dawson, Colm P.F. O'Donnell, Colin J. Morley, Susan M. Donath, Jasbir Sekhon, Peter G. Davis
The Journal of Pediatrics
June 2008 (Vol. 152, Issue 6, Pages 756-760)
Abstract | Full Text | Full-Text PDF (332 KB)

Objective

To evaluate the efficacy of first day of life pulse oximetry screening to detect congenital heart defects (CHDs).

Study design

We performed a population-based prospective multicenter study of postductal (foot) arterial oxygen saturation (SpO2) in apparently healthy newborns after transfer from the delivery suite to the nursery. SpO2 < 95% led to further diagnostic evaluations. Of 57,959 live births, 50,008 (86%) were screened. CHDs were prospectively registered and diagnosed in 658 newborns (1.1%), of whom 35 (5%) were classified as critical (ductus dependent, cyanotic).

Results

Of the infants screened, 324 (0.6%) failed the test. Of these, 43 (13%) had CHDs (27 critical), and 134 (41%) had pulmonary diseases or other disorders. The remaining 147 infants (45%) were healthy with transitional circulation. The median age for babies with CHDs at failing the test was 6 hours (range, 1-21 hours). For identifying critical CHDs, the pulse oximetry screening had a sensitivity rate of 77.1% (95% CI, 59.4-89.0), specificity rate of 99.4% (95% CI, 99.3-99.5), and a false-positive rate of 0.6% (95% CI, 0.5-0.7).

Conclusions

Early pulse oximetry screening promotes early detection of critical CHDs and other potentially severe diseases. The sensitivity rate for detecting critical CHDs is high, and the false-positive rate is low.

Abbreviations: CHD, Congenital heart defect, SpO2, Arterial oxygen saturation

a Department of Paediatrics, Vestfold Hospital, Tønsberg, Norway

b Department of Paediatrics, Buskerud Hospital, Drammen, Norway

c Department of Paediatrics, Bærum Hospital, Sandvika, Norway

d Department of Paediatrics, Sørlandet Hospital, Kristiansand, Norway

e Department of Paediatrics, Nordland Hospital, Bodø, Norway

f Department of Paediatrics, Akershus University Hospital, Nordbyhagen, Norway

g Department of Paediatrics, Innlandet Hospital, Lillehammer, Norway

h Department of Paediatrics, Telemark Hospital, Skien, Norway

i Department of Paediatrics, St Olav Hospital, Trondheim, Norway

j Department of Paediatrics, Sørlandet Hospital, Arendal, Norway

k Department of Paediatrics, Innlandet Hospital, Gjøvik, Norway

l Department of Paediatrics, Østfold Hospital, Fredrikstad, Norway

m Department of Paediatrics, Stavanger University Hospital, Stavanger, Norway

n Department of Paediatrics, The National Hospital, Oslo, Norway.

Reprint requests: Alf Meberg MD, PhD, Department of Paediatrics, Vestfold Hospital, 3103 Tønsberg, Norway.

Supported by grants from The Norwegian Society for Children with Heart Diseases, The Health Region South Trust, The Reneé and Bredo Grimsgaard Foundation, and Grethe Witzøe, Norway.

PII: S0022-3476(07)01187-0

doi:10.1016/j.jpeds.2007.12.043

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