Abstract
Pulse oximetry screening (POS) has been shown to be an effective and non-invasive investigation that can detect up to 50-70% of previously undiagnosed congenital heart defects (CHDs). The aims of this study were to assess the accuracy of POS in detection of CHDs and its impact on the clinical practice. All the eligible newborn infants born between Jan 2015 and Dec 2019 in busy regional neonatal unit were included in the prospective observational study. Of the 25185 eligible infants, 189 (0.8%) infants had a true positive results: 6 had critical CHDs, 9 serious or significant CHDs, and a further 156/189 infants had significant non-cardiac conditions. 43 infants who had a normal POS were later (post-hospital discharge) diagnosed with following category of CHDs: 1 critical, 15 serious, 20 significant and 7 non-significant CHDs. POS sensitivity for detection of critical CHD was 85.7% and its specificity was 99.3%. However, its sensitivity for detection of all the major CHDs needing surgery during infancy was 33%.ConclusionPulse oximetry screening showed moderate and high sensitivity in detection of undiagnosed critical CHDs, however it failed to detect two-third of the major CHDs. Our study further emphasises the significance of adopting routine POS to detect critical CHDs in the clinical practice. However, it also highlights the need to develop new, innovative methods to detect other major CHDs missed by pulse oximetry screening and other current screening tools.
Pulse Oximetry screening for congenital heart defects in newborn infants (PulseOx): a test accuracy study
