Critical CHD screening programme: a 3-year multicentre experience in Mexico.

Area of Science:

• Neonatology
• Pediatric Cardiology
• Public Health Screening

Background:

• Congenital heart defects (CHDs) are common birth defects, with critical CHDs affecting 1 in 4 newborns with heart defects.
• Mexico lacks comprehensive data on CHD prevalence, highlighting the need for effective screening programs.
• Pulse oximetry screening is a global standard, yet challenges in algorithm interpretation and data management persist.

Purpose of the Study:

• To report preliminary findings from a 3-year, multicenter pulse oximetry screening program in Mexico.
• To evaluate the impact of different screening algorithms on false-positive rates.
• To address critical challenges in implementing CHD screening programs.

Main Methods:

• A retrospective study analyzed data from 8960 newborns screened between February 2016 and July 2019 across five hospitals.
• Two algorithms, New Jersey and American Academy of Pediatrics, were consecutively implemented.
• The false-positive rate was calculated to assess algorithm effectiveness.

Main Results:

• The estimated prevalence of critical CHD was 6.69 per 10,000 newborns.
• The American Academy of Pediatrics algorithm yielded a lower false-positive rate (0.71%) compared to the New Jersey algorithm (1%).
• Algorithm choice did not significantly correlate with a reduction in the observable false-positive rate.

Conclusions:

• While algorithm choice may not be the primary driver of false-positive reduction, a systematic screening process enhances result confidence and newborn follow-up.
• Further investigation into other factors influencing false-positive rates is warranted.
• The study provides valuable preliminary data on critical CHD prevalence and screening program implementation in Mexico.