Early screening for critical congenital heart defects in asymptomatic newborns in Bursa province

Abstract

Objective: In this study, pulse oximetry screening results in the early diagnosis of critical congenital heart diseases (CCHD) will be evaluated.Methods: Eight-thousand two-hundred and eight of 10 200 newborns born between January 2014 and December 2014 were screened using pulse oximetry for the diagnosis of CCHD. Screening test was considered to be positive in the newborns whose saturation after 24 h from the birth with pulse oximetry was ≤95% and/or in the newborns who had a difference of ≥3% between the lower and right upper extremity.Results: Incidence of CCHD was 1 per 1000 live births. Coarctation of the aorta was the most commonly determined CCHD. Sensitivity, specificity, false negative rate and false positive rate of pulse oximetry in the diagnosis of CCHD were 60%, 99.8%, 40% and 0.12%, respectively. Seventy-five percent of the newborns who had a false negative diagnosis with pulse oximetry had coarctation of the aorta. Coarctation of the aorta was determined at a rate of 20% using CCHD screening.Conclusions: The diagnosis of coarctation of the aorta is missed in the newborns screened with pulse oximetry in the first 24–48 h after birth. Screening with pulse oximetry should be repeated for early diagnosis of coarctation of the aorta.