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A pilot implementation study to detect neonatal critical congenital heart disease using pulse oximetry screening in

Nana-Akyaa Yao1, Alexander Agyekum1, Abena Adaboh2

  • 1Pediatrics, Korle Bu Teaching Hospital, Accra, Ghana.

BMJ Global Health
|January 28, 2026
PubMed

Insights

Pulse oximetry screening (POS) successfully identified critical congenital heart disease (CCHD) in Ghana. This study demonstrates POS feasibility for early newborn detection in resource-limited settings.

Area of Science:

  • Neonatal Medicine
  • Public Health
  • Cardiology

Background:

  • Congenital heart disease (CHD) is a leading cause of newborn mortality globally.
  • Critical CHD (CCHD) requires early intervention for survival.
  • Pulse oximetry screening (POS) for CCHD is standard in high-income nations but limited in low-resource settings.

Purpose of the Study:

  • Assess the feasibility of routine POS implementation.
  • Estimate the incidence of CCHDs in Ghanaian hospitals.
  • Evaluate POS for early detection of CCHD in resource-limited environments.

Main Methods:

  • Prospective cohort study in two tertiary hospitals in Accra, Ghana.
  • Routine POS performed on eligible live-born infants within 48 hours.
  • Echocardiography referral for infants with positive POS screening.

Main Results:

  • Over 7889 deliveries, 96% of eligible infants (5725/5981) underwent POS.
  • 29 newborns failed screening; 19 cases of CHD were confirmed (0.33%).
  • Nine infants had CCHD (0.16%), and ten had non-CCHD (0.17%).

Conclusions:

  • POS implementation was feasible and successful in Ghanaian hospitals.
  • Systematic screening identified newborns with CHD who might otherwise have been missed.
  • Findings support integrating POS into routine newborn care in resource-limited settings.
Abstract

Keywords:
AfricaGlobal HealthHospital-based studyIndices of health and disease and standardisation of ratesPaediatrics

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