title: First day of life pulse oximetry screening to detect congenital heart defects.
abstract: OBJECTIVE
  To evaluate the efficacy of first day of life pulse oximetry screening to detect congenital heart defects (CHDs).
  
  
  METHODS
  We performed a population-based prospective multicenter study of postductal (foot) arterial oxygen saturation (SpO(2)) in apparently healthy newborns after transfer from the delivery suite to the nursery. SpO(2) < 95% led to further diagnostic evaluations. Of 57,959 live births, 50,008 (86%) were screened. In the screened population, 35 CHDs were [corrected] classified as critical (ductus dependent, cyanotic). CHDs were prospectively registered and diagnosed in 658/57,959 (1.1%) [corrected]
  
  
  RESULTS
  Of the infants screened, 324 (0.6%) failed the test. Of these, 43 (13%) had CHDs (27 critical), and 134 (41%) had pulmonary diseases or other disorders. The remaining 147 infants (45%) were healthy with transitional circulation. The median age for babies with CHDs at failing the test was 6 hours (range, 1-21 hours). For identifying critical CHDs, the pulse oximetry screening had a sensitivity rate of 77.1% (95% CI, 59.4-89.0), specificity rate of 99.4% (95% CI, 99.3-99.5), and a false-positive rate of 0.6% (95% CI, 0.5-0.7).
  
  
  CONCLUSIONS
  Early pulse oximetry screening promotes early detection of critical CHDs and other potentially severe diseases. The sensitivity rate for detecting critical CHDs is high, and the false-positive rate is low.
authors.affiliation: Department of Paediatrics, Vestfold Hospital, Tønsberg, Norway. alfmeb@start.no
authors.forename: Alf
authors.initials: A
authors.lastname: Meberg
authors.forename: Sabine
authors.initials: S
authors.lastname: Brügmann-Pieper
authors.forename: Reidar
authors.initials: R
authors.lastname: Due
authors.forename: Leif
authors.initials: L
authors.lastname: Eskedal
authors.forename: Ingebjørg
authors.initials: I
authors.lastname: Fagerli
authors.forename: Teresa
authors.initials: T
authors.lastname: Farstad
authors.forename: Dag Helge
authors.initials: DH
authors.lastname: Frøisland
authors.forename: Catharina Hovland
authors.initials: CH
authors.lastname: Sannes
authors.forename: Ole Jakob
authors.initials: OJ
authors.lastname: Johansen
authors.forename: Jasmina
authors.initials: J
authors.lastname: Keljalic
authors.forename: Trond
authors.initials: T
authors.lastname: Markestad
authors.forename: Egil Andre
authors.initials: EA
authors.lastname: Nygaard
authors.forename: Alet
authors.initials: A
authors.lastname: Røsvik
authors.forename: Inger Elisabeth
authors.initials: IE
authors.lastname: Silberg
mesh_terms: D000465:Algorithms; D006330:Heart Defects, Congenital / Q000175:diagnosis*; D006801:Humans; D007231:Infant, Newborn; D015997:Neonatal Screening; D010092:Oximetry; D011446:Prospective Studies