Pulse Oximetry and Perfusion Index Screening for Congenital Heart Defects: A Systematic Review and Meta-analysis

Area of Science:

• Neonatal Medicine
• Diagnostic Accuracy Studies
• Cardiology

Background:

• Congenital heart defects (CHDs) are the most common neonatal malformations and a significant cause of infant mortality.
• Effective and safe screening methods for CHDs are crucial for early diagnosis and intervention.
• Pulse oximetry (PO) and perfusion index (PI) are non-invasive measures with potential for CHD screening.

Approach:

• A systematic review and meta-analysis was conducted using studies from PubMed, Embase, and Cochrane Library up to October 1, 2021.
• Studies were selected based on PICOS criteria, and quality was assessed using QUADAS-2.
• Pooled sensitivity, specificity, and AUC were calculated using a randomized-effects model due to heterogeneity.

Key Points:

• Five studies encompassing 46,965 neonates were included in the meta-analysis.
• The combined sensitivity for CHD screening was 0.82 (95% CI, 0.53-0.95) and specificity was 0.97 (95% CI, 0.57-1.00).
• The area under the curve (AUC) was 0.92 (95% CI, 0.89-0.94), indicating high diagnostic accuracy.

Conclusions:

• The combination of PO and PI demonstrates significant effectiveness in screening for congenital heart defects.
• This combined method provides a reliable indicator for the likelihood of a neonate having a CHD.
• The findings support the use of PO and PI as valuable tools in neonatal CHD screening protocols.