All babies should under pulse oximetry screening for critical congenital heart defects in their first day of life, British experts say today.
Critical congenital heart defects occur in about two in 1,000 livebirths and require intervention in the first few weeks of life. These conditions are an important cause of neonatal mortality and morbidity, but rapid surgical and catheter interventions can have excellent outcomes in most cases.
Professor Andrew Ewer of Birmingham University, UK, and colleagues write in today’s (8 November) Lancet Child Adolescent Health that existing screening strategies for new-born babies, including antenatal ultrasound and postnatal examination, do not detect critical congenital heart defects before discharge in up to a third of cases, "and many of these infants will either collapse or die before diagnosis".
They explain that pulse oximetry screening improves early detection of these defects in new-born babies by identifying those with low oxygen saturations. It "has been shown to be simple, quick, painless, and cost-effective and acceptable to both staff and parents", they report.
Pulse oximetry screening was added to the recommended uniform screening panel in the USA in 2011.
The authors, all part of the European Pulse Oximetry Screening Workgroup, say that pulse oximetry screening should be recommended in all European countries, and that screening should occur after six hours of life or before discharge from the birthing centre, preferably within 24 hours of birth, in the right hand and either foot.
Professor Ewer said: "These recommendations are the culmination of almost a decade’s work driven by one focus; to prevent as many babies as possible from dying as a result of undetected heart defects. Surgical and catheter interventions now lead to excellent outcomes for most cases, but timely detection is essential."
Manzoni, P. et al. Pulse oximetry screening for critical congenital heart defects: a European consensus statement. Lancet Child Adolescent Health 8 November 2017; doi: 10.1016/S2352-4642(17)30066-4 [abstract]
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