Screening for Critical Congenital Heart Disease in Newborns

• Published in: Advances in pediatrics Vol. 62; no. 1; pp. 211 - 226
• Main Authors: Bruno, Christie J., DO, Havranek, Thomas, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.08.2015
• Subjects: Critical congenital heart disease; Critical Illness; Global Health; Heart Defects, Congenital - diagnosis; Heart Defects, Congenital - epidemiology; Humans; Incidence; Infant, Newborn; Internal Medicine; Neonatal Screening - methods; Newborns; Pediatrics; Prenatal Diagnosis - methods; Screening; Newborns; Critical congenital heart disease; Screening
• ISSN: 0065-3101; 1878-1926
• DOI: 10.1016/j.yapd.2015.04.002

CCHD affects more than 25% of neonates born with congenital heart disease. Patients with CCHD require timely intervention in the form of surgery or cardiac catheterization to survive. These interventions may improve survival and outcomes for these patients. There is strong evidence that performing newborn pulse oximetry screening after the first 24 hours of life may help to detect more than 1200 neonates in the United States each year with CCHD. Pulse oximetry screening for CCHD has been demonstrated to be reasonable to implement and seems to be cost-effective. There is evidence that asymptomatic patients with CCHD can be diagnosed before clinical presentation or cardiovascular collapse with this screening. Pulse oximeter screening has been endorsed by several national organizations as a valuable newborn screening tool. Implementation of pulse oximetry screening programs in a standardized manner with strong communication among all involved parties will likely improve outcomes as well. As we move forward, we as clinicians should work to have a centralized system of reporting positive CCHD results, prompt patient evaluation, and good follow-up for the families of those neonates with positive screening results. Achieving these objectives will likely help us to achieve the goal of improving outcomes of the most critical neonates with CCHD.