Pulse oximetry helps detect heart defects

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CCHD screening for infants proves sucessful in New Jersey
CCHD screening for infants proves sucessful in New Jersey

HealthDay News -- Pulse oximetry is fairly accurate for detecting critical congenital heart defects in asymptomatic newborns, results of a meta-analysis suggest.

Pulse oximetry detected these types of heart defects with a 76.5% sensitivity and a 99.9% specificity, which is comparable to other methods such as antenatal ultrasound and routine physical exam, Shakila Thangaratinam, PhD, of Queen Mary University of London, and colleagues reported in Lancet.

The false-positive rate was 0.14% and was dependent on the timing of the test. If performed after the first 24 hours from birth, the false-positive rate was 0.05%, compared with 0.50% if performed within the first 24 hours after birth (P=0.0017). The analysis included data from thirteen eligible studies involving 229,421 newborns.

"The findings of this meta-analysis provide compelling evidence for introduction of pulse oximetry as a screening method in clinical practice," the researchers wrote.

Pulse oximetry has already been adopted as part of the recommended uniform newborn screening panel in the United States, but other countries have yet to follow.

Devices are widely available, the procedure is noninvasive and easy and cost per screen is low, but follow-up after positive screens may be challenging, Alex R. Kemper, MD, MPH, of Duke University, and Gerard R. Martin, MD, of Children's National Medical Center in Washington, D.C., stated in an accompanying editorial. 

"Many hospitals do not have access to pediatric echocardiography, which is needed for newborn babies with a positive screen not attributable to another cause," they wrote.

Kemper and Martin expect the debate over whether pulse oximetry should be included in routine newborn screening and clinical care to continue until more data on the economics and outcomes associated with this method become available.

Thangaratinam S et al. Lancet. 2012; doi: 10.1016/S0140-6736(12)60107-X.

Kemper AR, Martin GR. Lancet 2012; doi: 10.1016/S0140-6736(12)60242-6.

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