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Pulse oximetry screening to detect critical congenital heart diseases in asymptomatic neonates

Shridhar Gopalakrishnan1, Saurabh Karmani2, Abhishek Pandey3

  • 1Associate Professor, Department of Pediatrics, Armed Forces Medical College, Pune, India.

Medical Journal, Armed Forces India
|April 19, 2021
PubMed

Insights

Pulse oximetry screening effectively detects critical congenital heart diseases (CCHDs) in newborns. This method offers high specificity and negative predictive value, improving early diagnosis and outcomes for CCHD.

Area of Science:

  • Neonatal Medicine
  • Cardiology
  • Public Health Screening

Background:

  • Critical congenital heart diseases (CCHDs) are life-threatening duct-dependent defects requiring early intervention.
  • A significant proportion of neonates with CCHDs are discharged undetected, leading to poorer outcomes.
  • Pulse oximetry screening is emerging as a key diagnostic tool for CCHDs in developed nations.

Purpose of the Study:

  • To evaluate the effectiveness of pulse oximetry screening in detecting critical congenital heart diseases (CCHDs) in asymptomatic neonates.
  • To determine the sensitivity, specificity, and predictive values of pulse oximetry for CCHD detection.

Main Methods:

  • A prospective observational study screened 1855 asymptomatic neonates after 24 hours of life using Masimo pulse oximetry.
  • The standard American Academy of Pediatrics algorithm was employed for screening.
  • Positive screens were confirmed with echocardiography; negative screens involved clinical follow-up and readmission monitoring.

Main Results:

  • Pulse oximetry screening demonstrated high specificity (99.29%) and negative predictive value (99.94%) for CCHD detection.
  • The sensitivity was 75%, with a positive predictive value of 18.75%.
  • Screening was performed efficiently, taking a mean of 3.5 minutes per neonate.

Conclusions:

  • Pulse oximetry screening between 24 and 48 hours of life enhances CCHD detection in asymptomatic neonates.
  • The screening method exhibits high specificity and negative predictive value, with a low false positivity rate.
  • This approach improves the early identification of CCHDs, contributing to better neonatal outcomes.
Abstract

Keywords:
Asymptomatic neonatesCritical congenital heart diseasesDiagnostic accuracyPulse oximetry screening

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