This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow View responses
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Web of Science (21)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Koppel, R. I.
Right arrow Articles by Bierman, F. Z.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Koppel, R. I.
Right arrow Articles by Bierman, F. Z.
Related Collections
Right arrow Heart & Blood Vessels
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

PEDIATRICS Vol. 111 No. 3 March 2003, pp. 451-455

Effectiveness of Pulse Oximetry Screening for Congenital Heart Disease in Asymptomatic Newborns

Robert I. Koppel, MD*, Charlotte M. Druschel, MD, MPH{ddagger}, Tonia Carter, MS{ddagger}, Barry E. Goldberg, MD§, Prabhu N. Mehta, MD§, Rohit Talwar, MD§ and Fredrick Z. Bierman, MD*

* Department of Pediatrics, Schneider Children’s Hospital, New Hyde Park, New York
{ddagger} Department of Health, New York State, Albany, New York
§ Department of Pediatrics, Good Samaritan Hospital, West Islip, New York

--> Objective. To determine the sensitivity, specificity, predictive value, and accuracy of a program of pulse oximetry screening of asymptomatic newborns for critical congenital cardiovascular malformation (CCVM).

Methods. Pulse oximetry was performed on asymptomatic newborns in the well-infant nurseries of 2 hospitals. Cardiac ultrasound was performed on infants with positive screens (saturation <=95% at >24 hours). Data regarding true and false positives as well as negatives were collected and analyzed.

Results. Oximetry was performed on 11 281 asymptomatic newborns, and 3 cases of CCVM were detected (total anomalous pulmonary venous return x2, truncus arteriosus). During the study interval, there were 9 live births of infants with CCVM from a group of 15 fetuses with CCVM detected by fetal echocardiography. Six infants with CCVM were symptomatic before screening. There was 1 false-positive screen. Two infants with negative screens were readmitted (coarctation, hypoplastic left pulmonary artery with aorto-pulmonary collaterals). Other cardiac diagnoses in the database search were nonurgent, including cases of patent foramen ovale, peripheral pulmonic stenosis, and ventricular septal defect. The prevalence of critical CCVM among all live births was 1 in 564 and among the screened population was 1 in 2256 (sensitivity: 60%; specificity: 99.95%; positive predictive value: 75%; negative predictive value: 99.98%; accuracy: 99.97%).

Conclusions. This screening test is simple, noninvasive, and inexpensive and can be administered in conjunction with state-mandated screening. The false-negative screen patients had lesions not amenable to detection by oximetry. The sensitivity, specificity, and predictive value in this population are satisfactory, indicating that screening should be applied to larger populations, particularly where lower rates of fetal detection result in increased CCVM prevalence in asymptomatic newborns.

Key Words: pulse • oximetry • screening • newborn • heart

Abbreviations: CCVM, congenital cardiovascular malformation • CMR, Congenital Malformations Registry

Received for publication Feb 7, 2002; Accepted Aug 1, 2002.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?


This article has been cited by other articles:


Home page
 BMJHome page
A. de-Wahl Granelli, M. Wennergren, K. Sandberg, M. Mellander, C. Bejlum, L. Inganas, M. Eriksson, N. Segerdahl, A. Agren, B.-M. Ekman-Joelsson, et al.
Impact of pulse oximetry screening on the detection of duct dependent congenital heart disease: a Swedish prospective screening study in 39 821 newborns
BMJ, January 13, 2009; 338(jan08_2): a3037 - a3037.
[Abstract] [Full Text] [PDF]

Home page
 Arch Pediatr Adolesc MedHome page
R.-K. R. Chang, M. Gurvitz, and S. Rodriguez
Missed Diagnosis of Critical Congenital Heart Disease
Arch Pediatr Adolesc Med, October 1, 2008; 162(10): 969 - 974.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
D. M. Sendelbach, G. L. Jackson, S. S. Lai, D. E. Fixler, E. K. Stehel, and W. D. Engle
Pulse Oximetry Screening at 4 Hours of Age to Detect Critical Congenital Heart Defects
Pediatrics, October 1, 2008; 122(4): e815 - e820.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
A. H. Schultz, A. R. Localio, B. J. Clark, C. Ravishankar, N. Videon, and S. E. Kimmel
Epidemiologic Features of the Presentation of Critical Congenital Heart Disease: Implications for Screening
Pediatrics, April 1, 2008; 121(4): 751 - 757.
[Abstract] [Full Text] [PDF]

Home page
 Arch. Dis. Child. Fetal Neonatal Ed.Home page
P. Valmari
Should pulse oximetry be used to screen for congenital heart disease?
Arch. Dis. Child. Fetal Neonatal Ed., May 1, 2007; 92(3): F219 - F224.
[Abstract] [Full Text] [PDF]

Home page
 Arch. Dis. Child. Fetal Neonatal Ed.Home page
S. Thangaratinam, J. Daniels, A. K Ewer, J. Zamora, and K. S Khan
Accuracy of pulse oximetry in screening for congenital heart disease in asymptomatic newborns: a systematic review
Arch. Dis. Child. Fetal Neonatal Ed., May 1, 2007; 92(3): F176 - F180.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
M. R. Liske, C. S. Greeley, D. J. Law, J. D. Reich, W. R. Morrow, H. S. Baldwin, T. P. Graham, A. W. Strauss, A. L. Kavanaugh-McHugh, and W. F. Walsh
Report of the Tennessee Task Force on Screening Newborn Infants for Critical Congenital Heart Disease
Pediatrics, October 1, 2006; 118(4): e1250 - e1256.
[Abstract] [Full Text] [PDF]

Home page
 Arch. Dis. Child. Fetal Neonatal Ed.Home page
C Patton and E Hey
How effectively can clinical examination pick up congenital heart disease at birth?
Arch. Dis. Child. Fetal Neonatal Ed., July 1, 2006; 91(4): F263 - F267.
[Abstract] [Full Text] [PDF]

Home page
 Journal Watch CardiologyHome page
Screening for Congenital Heart Disease
Journal Watch Cardiology, April 11, 2003; 2003(411): 3 - 3.
[Full Text]

Home page
 JWatch GeneralHome page
Screening for Congenital Heart Disease
Journal Watch (General), March 25, 2003; 2003(325): 2 - 2.
[Full Text]

eLetters:

Read all eLetters

The Cost of Newborn Hearing Screening
Scott D. Grosse
Pediatrics Online, 17 Mar 2003 [Full text]
Re: The Cost of Newborn Hearing Screening
Robert I Koppel
Pediatrics Online, 17 Mar 2003 [Full text]
Screening of CHD: clinicians vs. pulse oximetry
Kenneth L. Harkavy
Pediatrics Online, 17 Apr 2003 [Full text]
Re: Screening of CHD: clinicians vs. pulse oximetry
Robert I Koppel
Pediatrics Online, 2 May 2003 [Full text]