ScienceDaily: Newest Screen for Newborns Will Indicate Heart Problems

About 1 in every 120 babies are born with congenital heart disease (CHD), of which about 25 percent is critical, requiring special care early in life. CHD is responsible for more deaths in the first year of life than any other birth defect, but often outcomes can be improved with early detection.

Now a group of physicians and scientists has published an important paper that recommends strategies for national screening for critical CHD, using a simple, noninvasive test called pulse oximetry that measures oxygen in blood. Low oxygen levels would trigger further investigation.

The screening strategy report was published in the journal Pediatrics on Aug. 22.

"Screening for low-blood oxygen saturation can be an effective way to identify otherwise well-appearing babies who have undetected critical CHD," said one of the report's authors, Alex Kemper, M.D., Associate Professor of Pediatrics at Duke University Medical Center. "One of the biggest challenges in implementing screening will be the follow-up after a positive screen."

Many of the identified babies will require an evaluation by a pediatric cardiologist or an echocardiogram, or ultrasound of the heart, before they can go home. Because not all hospitals have these services, some babies may need to be transferred to other hospitals.

Now a group of physicians and scientists has published an important paper that recommends strategies for national screening for critical CHD, using a simple, noninvasive test called pulse oximetry that measures oxygen in blood. Low oxygen levels would trigger further investigation.

The screening strategy report was published in the journal Pediatrics on Aug. 22.

"Screening for low-blood oxygen saturation can be an effective way to identify otherwise well-appearing babies who have undetected critical CHD," said one of the report's authors, Alex Kemper, M.D., Associate Professor of Pediatrics at Duke University Medical Center. "One of the biggest challenges in implementing screening will be the follow-up after a positive screen."

Many of the identified babies will require an evaluation by a pediatric cardiologist or an echocardiogram, or ultrasound of the heart, before they can go home. Because not all hospitals have these services, some babies may need to be transferred to other hospitals.

"Therefore, it is very important to avoid false positive screening results," Kemper said. "We believe that the strategy we have developed will identify most cases but also have a false positive rate of less than 1 percent."

The group's recommendations are based on large studies conducted in the United States and Europe. However, there are still many unanswered questions about how to best screen, including timing and the standards for a positive screen.

For example, the algorithm's usual cutoff point for oxygen saturation may need to be adjusted for babies in high-altitude nurseries, where blood oxygen levels may be normally slightly lower...

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