open access

Vol 70, No 4 (2012)
Original articles
Published online: 2012-04-24
Submitted: 2012-12-28
Get Citation

Early screening for critical congenital heart defects in asymptomatic newborns in Mazovia province: experience of the POLKARD pulse oximetry programme 2006–2008 in Poland

Anna Turska−Kmieć, Maria Katarzyna Borszewska−Kornacka, Witold Błaż, Wanda Kawalec, Małgorzata Żuk
Kardiol Pol 2012;70(4):376-382.

open access

Vol 70, No 4 (2012)
Original articles
Published online: 2012-04-24
Submitted: 2012-12-28

Abstract


Background: Early diagnosis of critical congenital heart defects (CCHD) may be missed both during prenatal echocardiography and the short stay in the neonatal nursery, leading to circulatory collapse or death of the newborn before readmission to hospital.
Aim: To assess the usefulness of pulse oximetry as a screening test in early diagnosis of CCHD in newborns.
Methods: A prospective screening pulse oximetry test was conducted in 51 neonatal units in the Mazovia province of Poland as part of the POLKARD 2006–2008 programme between 16 January, 2007 and 31 January, 2008. Newborns with no circulatory symptoms or coexisting diseases, and no prenatal diagnosis, were enrolled. The test was performed between the 2nd and 24th hours of life in stable newborns. A double arterial oxygen saturation (SpO2) reading < 95% on a lower extremity led to cardiovascular evaluation and echocardiography.
Results: From a population of 52,993 newborns (14.2% of births in Poland), a group of 51,698 asymptomatic infants was isolated. CCHD was diagnosed solely by pulse oximetry in 15 newborns, which constituted 18.3% of all CCHD; 14 (0.026%) false positives were obtained and there were four false negative results. The sensitivity of the test was 78.9% and specificity 99.9%. The positive predictive value was 51.7% and negative 99.9%.
Conclusions: Pulse oximetry fulfilling the screening test criteria, performed on a large population of newborns in Poland, proved useful in supporting prenatal diagnostics and postnatal physical examination in the early detection of initially asymptomatic CCHD. Good sensitivity and specificity results of the pulse oximetry test have allowed it to be recommended for use in neonatal units nationwide.

Abstract


Background: Early diagnosis of critical congenital heart defects (CCHD) may be missed both during prenatal echocardiography and the short stay in the neonatal nursery, leading to circulatory collapse or death of the newborn before readmission to hospital.
Aim: To assess the usefulness of pulse oximetry as a screening test in early diagnosis of CCHD in newborns.
Methods: A prospective screening pulse oximetry test was conducted in 51 neonatal units in the Mazovia province of Poland as part of the POLKARD 2006–2008 programme between 16 January, 2007 and 31 January, 2008. Newborns with no circulatory symptoms or coexisting diseases, and no prenatal diagnosis, were enrolled. The test was performed between the 2nd and 24th hours of life in stable newborns. A double arterial oxygen saturation (SpO2) reading < 95% on a lower extremity led to cardiovascular evaluation and echocardiography.
Results: From a population of 52,993 newborns (14.2% of births in Poland), a group of 51,698 asymptomatic infants was isolated. CCHD was diagnosed solely by pulse oximetry in 15 newborns, which constituted 18.3% of all CCHD; 14 (0.026%) false positives were obtained and there were four false negative results. The sensitivity of the test was 78.9% and specificity 99.9%. The positive predictive value was 51.7% and negative 99.9%.
Conclusions: Pulse oximetry fulfilling the screening test criteria, performed on a large population of newborns in Poland, proved useful in supporting prenatal diagnostics and postnatal physical examination in the early detection of initially asymptomatic CCHD. Good sensitivity and specificity results of the pulse oximetry test have allowed it to be recommended for use in neonatal units nationwide.
Get Citation

Keywords

congenital heart defect; pulse oximetry; newborn; screening

About this article
Title

Early screening for critical congenital heart defects in asymptomatic newborns in Mazovia province: experience of the POLKARD pulse oximetry programme 2006–2008 in Poland

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 70, No 4 (2012)

Pages

376-382

Published online

2012-04-24

Bibliographic record

Kardiol Pol 2012;70(4):376-382.

Keywords

congenital heart defect
pulse oximetry
newborn
screening

Authors

Anna Turska−Kmieć
Maria Katarzyna Borszewska−Kornacka
Witold Błaż
Wanda Kawalec
Małgorzata Żuk

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By "Via Medica sp. z o.o." sp.k., Świętokrzyska 73 street, 80–180 Gdańsk, Poland

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail: viamedica@viamedica.pl