Determining the incidence of heart malformations in neonates: A novel and clinically approved solution

Arash Bordbar; Mandana Kashaki; Maryam Vafapour; Amir A Sepehri

doi:10.3389/fped.2023.1058947

Determining the incidence of heart malformations in neonates: A novel and clinically approved solution

Front Pediatr. 2023 Mar 15:11:1058947. doi: 10.3389/fped.2023.1058947. eCollection 2023.

Authors

Arash Bordbar¹, Mandana Kashaki¹, Maryam Vafapour², Amir A Sepehri³

Affiliations

¹ Shahid Akbarabadi Clinical Research & Development Unit (ShACRDU), Iran University of Medical Sciences (IUMS), Tehran, Iran.
² Department of Pediatrics, Ali-Asghar Children's Hospital, Iran University of Medical Sciences, Tehran, Iran.
³ Biomedical R&D Department, CAPIS Research and Development Co., Mons, Belgium.

Abstract

Background: Screening for critical congenital heart defects should be performed as early as possible and is essential for saving the lives of children and reducing the incidence of undetected adult congenital heart diseases. Heart malformations remain unrecognized at birth in more than 50% of neonates at maternity hospitals. Accurate screening for congenital heart malformations is possible using a certified and internationally patented digital intelligent phonocardiography machine. This study aimed to assess the actual incidence of heart defects in neonates. A pre-evaluation of the incidence of unrecognized severe and critical congenital heart defects at birth in our well-baby nursery was also performed.

Methods: We conducted the Neonates Cardiac Monitoring Research Project (ethics approval number: IR-IUMS-FMD. REC.1398.098) at the Shahid Akbarabadi Maternity Hospital. This study was a retrospective analysis of congenital heart malformations observed after screening 840 neonates. Using a double-blind format, 840 neonates from the well-baby nursery were randomly chosen to undergo routine clinical examinations at birth and digital intelligent phonocardiogram examinations. A pediatric cardiologist performed echocardiography for each neonate classified as having abnormal heart sounds using an intelligent machine or during routine medical examinations. If the pediatric cardiologist requested a follow-up examination, then the neonate was considered to have a congenital heart malformation, and the cumulative incidence was calculated accordingly.

Results: The incidence of heart malformations in our well-baby nursery was 5%. Furthermore, 45% of heart malformations were unrecognized in neonates at birth, including one critical congenital heart defect. The intelligent machine interpreted innocent murmurs as healthy heart sound.

Conclusion: We accurately and cost-effectively screened for congenital heart malformations in all neonates in our hospital using a digital intelligent phonocardiogram. Using an intelligent machine, we successfully identified neonates with CCHD and congenital heart defects that could not be detected using standard medical examinations. The Pouya Heart machine can record and analyze sounds with a spectral power level lower than the minimum level of the human hearing threshold. Furthermore, by redesigning the study, the identification of previously unrecognized heart malformations could increase to 58%.

Keywords: Pouya Heart; congenital heart diseases; congenital heart malformations; critical congenital heart defects; innocent murmurs; intelligent phonocardiogram; intelligent phonocardiography.

Grants and funding

This study was funded by the Shahid Akbarabadi Clinical R&D Unit, Iran University of Medical Sciences (ethics approval number: IR-IUMS-FMD. REC.1398.098). This study received funding for the publication fee from CAPIS. However, the funder was not involved in the study design, collection, analysis, interpretation of data, writing of this article, or decision to submit it for publication. All authors declare no other competing interests.