Heart Defects In Newborn Babies Research Articles

Pulse Oximetry Screening for Critical Congenital Heart Defects in Asymptomatic Newborn Babies

Summary Background Screening for critical congenital heart defects in newborn babies can aid in early recognition, with the prospect of improved outcome. We assessed the performance of pulse oximetry as a screening method for the detection of critical congenital heart defects in asymptomatic newborn babies. Methods In this systematic review, we searched Medline (1951–2011), Embase (1974–2011), Cochrane Library (2011), and Scisearch (1974–2011) for relevant citations with no language restriction. We selected studies that assessed the accuracy of pulse oximetry for the detection of critical congenital heart defects in asymptomatic newborn babies. Two reviewers selected studies that met the predefined criteria for population, tests, and outcomes. We calculated sensitivity, specificity, and corresponding 95% CIs for individual studies. A hierarchical receiver operating characteristic curve was fitted to generate summary estimates of sensitivity and specificity with a random effects model. Findings We screened 552 studies and identified 13 eligible studies with data for 229 421 newborn babies. The overall sensitivity of pulse oximetry for detection of critical congenital heart defects was 76·5% (95% CI 67·7–83·5). The specificity was 99·9% (99·7–99·9), with a false-positive rate of 0·14% (0·06–0·33). The false-positive rate for detection of critical congenital heart defects was particularly low when newborn pulse oximetry was done after 24 h from birth than when it was done before 24 h (0·05% [0·02–0·12] vs 0·50 [0·29–0·86]; p=0·0017). Interpretation Pulse oximetry is highly specific for detection of critical congenital heart defects with moderate sensitivity, that meets criteria for universal screening. Funding None.

Pulse oximetry screening for critical congenital heart defects in asymptomatic newborn babies: a systematic review and meta-analysis

Objective: This study assessed the performance of pulse oximetry as a screening method for the detection of critical congenital heart defects (CHD) in asymptomatic newborn babies. Background: Screening for critical congenital heart defects in newborn babies can aid in early recognition, which may lead to improved outcome. The potential predictive value of using pulse oximetry to screen for significant cyanotic CHD in newborns has been unclear. One difficulty of determining the potential value of universal screening of newborns with pulse oximetry from previous studies is that the relative infrequency of CHD made any individual study less able to demonstrate benefit. This meta-analysis with 229,421 newborn babies makes this a more powerful study. Methods: In this meta-analysis, the authors searched Medline (1951–2011), Embase (1974–2011), Cochrane Library (2011), and SciSearch (1974–2011) for studies that assessed the accuracy of pulse oximetry for the detection of critical CHD in asymptomatic newborn babies. Two reviewers selected studies that met the predefined criteria for population, tests, and outcomes, and sensitivity, specificity, and corresponding 95% CIs for individual studies were determined. Results: This meta-analysis identified 13 studies, published from 2001 to 2011, that screened 229,421 asymptomatic newborn infants for critical CHD (defined as disorders from which infants died or required invasive procedures or surgery in the first 28 days of life). The overall sensitivity of pulse oximetry for detection of critical CHD was 76.5%. The specificity was 99.9%, with a false-positive rate of 0.14%. Measurement of pulse oximetry before 24 h of age improved sensitivity from 77.5% to 84.8% (a nonsignificant difference) but increased the false-positive rate from 0.05% to 0.5% (a significant difference; p = .0017). Location of the pulse oximeter probe did not affect sensitivity or the frequency of false-positive results. Thangaratinam and colleagues concluded that pulse oximetry is a highly specific test for detection of critical CHD in newborn infants, and that the false-positive rate is low, especially when done after 24 h of age. Conclusion: Pulse oximetry is highly specific and moderately sensitive for detection of critical CHD and it meets the criteria for universal screening.

Pulse oximetry screening for critical congenital heart defects in asymptomatic newborn babies: a systematic review and meta-analysis

Screening for critical congenital heart defects in newborn babies can aid in early recognition, with the prospect of improved outcome. We assessed the performance of pulse oximetry as a screening method for the detection of critical congenital heart defects in asymptomatic newborn babies. In this systematic review, we searched Medline (1951-2011), Embase (1974-2011), Cochrane Library (2011), and Scisearch (1974-2011) for relevant citations with no language restriction. We selected studies that assessed the accuracy of pulse oximetry for the detection of critical congenital heart defects in asymptomatic newborn babies. Two reviewers selected studies that met the predefined criteria for population, tests, and outcomes. We calculated sensitivity, specificity, and corresponding 95% CIs for individual studies. A hierarchical receiver operating characteristic curve was fitted to generate summary estimates of sensitivity and specificity with a random effects model. We screened 552 studies and identified 13 eligible studies with data for 229,421 newborn babies. The overall sensitivity of pulse oximetry for detection of critical congenital heart defects was 76·5% (95% CI 67·7-83·5). The specificity was 99·9% (99·7-99·9), with a false-positive rate of 0·14% (0·06-0·33). The false-positive rate for detection of critical congenital heart defects was particularly low when newborn pulse oximetry was done after 24 h from birth than when it was done before 24 h (0·05% [0·02-0·12] vs 0·50 [0·29-0·86]; p=0·0017). Pulse oximetry is highly specific for detection of critical congenital heart defects with moderate sensitivity, that meets criteria for universal screening. None.