Pulse oximetry identifies newborns’ heart defects

Universal newborn screening for critical congenital heart defects (CCHD) using pulse oximetry has been successfully implemented in New Jersey with minimal burden on hospitals staffs, according to the first analysis of process data from the Centers for Disease Control and Prevention (CDC).

Pulse oximetry is a noninvasive technology that detects hypoxemia, a clinical sign of CCHD. Without early detection, newborns with CCHD are at risk of death in the first days or weeks of life. Pulse oximetry screening also may identify other medical conditions such as pulmonary abnormalities and sepsis.

New Jersey was the first state to mandate statewide CCHD screening with pulse oximetry in August 2011 after the US Health and Human Services Secretary’s Advisory Committee on Heritable Disorders in Newborns and Children recommended it. Pulse oximetry was added to the Recommended Uniform Newborn Screening Panel in September 2011.

Preliminary data indicate that 98% of 25,214 newborns were screened during the first 3 months following New Jersey’s implementation of the protocol: 12 babies showed positive screening results; 2 positive screens were newly diagnosed with CCHD that without pulse oximetry screening might have resulted in death or disability.

WIthin 5 months after statewide implementation, all birthing facilities visited by the CDC and the New Jersey Department of Health were found to be routinely screening newborns in their well-baby nurseries and neonatal intensive care units and reporting data to the state health department. The hospitals noted minimal increases in workload or additional duties related to screening data collection, tracking procedures, electronic medical record capabilities, and data reporting among nursing staff members.

Congenital heart disease occurs in approximately 1% of all live births, and 25% of newborns with CCHD require cardiac surgery or catheterization before the children’s first birthdays.

In addition to New Jersey, 18 other states have introduced or enacted legislation requiring newborn screening with pulse oximetry.