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

S L Jiang1, Y J Zhan1, P Yan2

  • 1Department of Pediatrics, West China Second University Hospital, Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, Sichuan University, Chengdu, People's Republic of China.

American Journal of Perinatology
|May 17, 2022
PubMed

Insights

Pulse oximetry (PO) and perfusion index (PI) effectively screen for congenital heart defects (CHDs) in newborns. This systematic review and meta-analysis confirms their combined diagnostic accuracy for identifying critical CHDs.

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.

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