Pulse oximetry screening and home birth

Abstract

In the US, pulse oximetry screening for detection of critical congenital heart disease has become accepted as an important aspect of newborn screening. Systems to implement pulse oximetry screening are being developed and put in place across the country. In this issue of The Journal, Narayen et al evaluate an approach to pulse oximetry screening developed for the Netherlands, where home birth and very early discharge from the hospital after birth are much more common. To develop an appropriate system for home birth, the authors had to alter the timing of administration of pulse oximetry. They also had to train community midwives and provide each midwife with a handheld pulse oximeter. The results were encouraging in that such screening and follow-up appears feasible. Neonatal pathology other than critical congenital heart disease was detected and the number of false positive screens was low. However, it is important to emphasize that this approach only works with the development of a regional system to support it. These results would not support the use of pulse oximetry in individual home births without the appropriate healthcare system as supporting infrastructure.Article page 188▶ In the US, pulse oximetry screening for detection of critical congenital heart disease has become accepted as an important aspect of newborn screening. Systems to implement pulse oximetry screening are being developed and put in place across the country. In this issue of The Journal, Narayen et al evaluate an approach to pulse oximetry screening developed for the Netherlands, where home birth and very early discharge from the hospital after birth are much more common. To develop an appropriate system for home birth, the authors had to alter the timing of administration of pulse oximetry. They also had to train community midwives and provide each midwife with a handheld pulse oximeter. The results were encouraging in that such screening and follow-up appears feasible. Neonatal pathology other than critical congenital heart disease was detected and the number of false positive screens was low. However, it is important to emphasize that this approach only works with the development of a regional system to support it. These results would not support the use of pulse oximetry in individual home births without the appropriate healthcare system as supporting infrastructure. Article page 188▶ Pulse Oximetry Screening for Critical Congenital Heart Disease after Home Birth and Early DischargeThe Journal of PediatricsVol. 170PreviewTo assess the feasibility of pulse oximetry (PO) screening in settings with home births and very early discharge. We assessed this with an adapted protocol in The Netherlands. Full-Text PDF