Screening all newborns for heart defects could save hundreds of lives a year
Researchers said scan was cheap and non-invasive
07:52 GMT, 2 May 2012
All babies should be screened at birth for heart defects using a cheap simple test that will pick up three out of four affected infants, claim researchers.
Around 5,000 babies are born each year suffering from congenital heart disease, with around half diagnosed before they leave hospital.
But the remaining babies who show no visible signs of the condition are at risk of life-threatening problems unless they are treated promptly.
A pulse oximetry screening takes only a couple of minutes and can be carried out by a midwife
A new study provides ‘overwhelming evidence’ that using a sensor on the foot to measure blood oxygen levels could pick up three-quarters of babies within 24 hours of birth.
Researchers at Queen Mary, University of London and the University of Birmingham, reviewed 13 studies looking at the ability of a non-invasive test called pulse oximetry to accurately detect heart defects in newborns.
Pulse oximetry measures the amount of oxygen circulating in the blood stream using a sensor placed on a thin part of the body such as the fingertip, or earlobe, or in the case of the newborn, the foot.
The new research, which examined data on 230,000 babies, found pulse oximetry can successfully detect 76 per cent of birth defects.
It is most accurate when used to screen babies around 24 hours after birth, says a report in The Lancet medical journal.
It also showed the test seldom wrongly diagnosed healthy babies as having a heart defect, which means very few parents would be subject to unnecessary stress from getting an incorrect diagnosis of a heart defect.
Researchers say heart screening could easily be combined with existing routine checks for other, less common types of birth defects in newborn babies.
Currently some heart defects are picked up by ultrasound scan carried out when a woman is around 20 weeks pregnant or by physical examination of the newborn baby, but many cases are missed.
The most serious cases can be fatal if untreated, but surgery has a high success rate if carried out as soon as possible.
Lead researcher Dr Shakila Thangaratinam, a Clinical Senior Lecturer at Queen Mary, University of London, said ‘Heart defects in newborn babies are thankfully rare but their potential impact is devastating.
‘This study is really important because by including such large numbers of babies, we can show that pulse oximetry is effective at picking up defects, without misdiagnosing healthy babies. Previous research also indicates that it is cost-effective.
‘This study is the best evidence yet that using pulse oximetry to screen for heart defects should be included in the newborn health checks.’
Separate research shows the 6.24 cost per test would be easily recouped from savings made by carrying out surgery earlier in some cases and cutting down complications needing hospital care.
At present the US is the only country to have adopted routine pulse oximetry screening.
Professor Peter Weissberg, Medical Director at the British Heart Foundation (BHF), said ‘This analysis provides a compelling case for the wider use of pulse oximetry to screen for congenital heart defects in newborn babies.
‘It is a simple, cheap and non-invasive test, but it will have to be supported by echocardiography services to determine the nature of the heart defect in babies with low oxygen levels.
‘The BHF has funded specialist training for people who perform ultrasound scans during pregnancy, so they are able to spot congenital heart defects in the womb before the baby is born.
‘The combination of this expert screening before and after birth should provide a powerful strategy for identifying babies with serious heart defects, so that they can be promptly treated.’