A quick, non-invasive test that measures blood oxygen levels in newborns can detect cases of life-threatening congenital heart defects effectively, researchers report today.
The UK’s largest pulse oximetry test accuracy study ascertained that the simple screening technique was far more effective than standard approaches, prompting researchers, writing in The Lancet online, to call for its use to be standard.
Dr Andrew Ewer from the University of Birmingham and Birmingham Women’s Hospital, Birmingham, England, found that pulse oximetry detected 75 per cent of critical cases and 49 per cent of all major congenital heart defects.
Between February 2008 and January 2009, more than 20 000 apparently healthy newborn babies from six maternity units across the UK were screened with pulse oximetry before they were discharged from hospital and were followed up to 12 months of age.
The detection rate of pulse oximetry, after excluding 35 cases of suspected congenital heart defects following antenatal ultrasound, was 58 per cent for critical cases and 28 per cent for all major cases.
When the test was combined with routine ultrasound and newborn physical examination, it improved the detection of critical congenital heart defects to 92 per cent. No babies died from undiagnosed heart disease.
"Pulse oximetry is a safe, non-invasive, feasible, and reasonably accurate test, which has sensitivity that is better than that of antenatal screening and clinical examination,” say the authors.
"The results of this study enhance the strong evidence that indicates the potential benefits of pre-discharge pulse oximetry screening as a routine procedure."
In a Comment, William Mahle from Emory University School of Medicine, Atlanta, USA and Robert Koppel from Cohen Children’s Medical Center, New York, USA, say: "Health-care systems in the developed world are already heavily burdened. Yet the compelling data provided by Ewer and colleagues support inclusion of pulse oximetry into the care of the newborn baby."
Amy Thompson, Senior Cardiac Nurse at the British Heart Foundation, described the research as “promising”.
“Not all babies who are born with a heart defect will show any signs or symptoms, so problems can go unnoticed. This is a promising piece of research which shows how a quick and simple test could help to detect more heart defects and make a real difference,” she said.”
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