Effectiveness of the critical congenital heart disease screening program for early diagnosis of cardiac abnormalities in newborn infants

Saudi Med J. 2017 Oct;38(10):1019-1024. doi: 10.15537/smj.2017.10.20295.

Abstract

To evaluate the effectiveness of critical congenital heart disease (CCHD) screening program for early diagnosis of cardiac anomalies in newborn infants. Methods: This is a hospital-based prospective cross-sectional study conducted in the Pediatric and Neonatology Department, King Fahad Hospital at Albaha, Saudi Arabia, between February 2016 and February 2017. Results: We screened 2961 (95.4%) of 3103 patients in a nursery unit; 142 (4.6%) patients were not screened. The test was positive in 114 (3.9%) patients and negative in 2847 (96.1%). There were 94 (3.2%) false positives and 20 (0.7%) true positives. Critical cardiac defects were diagnosed in 7 (0.2%) patients of all screened infants, and severe pulmonary hypertension was diagnosed in 13 (0.4%) patients. True negative results were found in 2841(96%) patients, and no cardiac defect was diagnosed, whereas false negative results were seen in 6 (0.2%) patients diagnosed with ventricular septal defect. The sensitivity was 77%, and the specificity was very high at 97%, with a positive predictive value of 18%, and a negative predictive value of 99.8% (95% confidence interval 13.78-19.18, p=0.0001). Conclusion: Pulse oximetry was found to be easy, safe, sensitive, and highly specific for diagnosis of CCHD.

MeSH terms

  • Cross-Sectional Studies
  • Ductus Arteriosus, Patent / diagnosis
  • Ductus Arteriosus, Patent / metabolism
  • Early Diagnosis
  • Female
  • Foramen Ovale, Patent / diagnosis
  • Foramen Ovale, Patent / metabolism
  • Heart Defects, Congenital / diagnosis*
  • Heart Defects, Congenital / metabolism
  • Heart Septal Defects, Ventricular / diagnosis
  • Heart Septal Defects, Ventricular / metabolism
  • Humans
  • Hypertension, Pulmonary / diagnosis
  • Hypertension, Pulmonary / metabolism
  • Infant, Newborn
  • Male
  • Mass Screening
  • Neonatal Screening*
  • Oximetry*
  • Prospective Studies
  • Saudi Arabia
  • Sensitivity and Specificity
  • Severity of Illness Index