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.
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.
  
  
  OBJECTIVE
  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 2(nd) and 24(th) hours of life in stable newborns. A double arterial oxygen saturation (SpO(2)) 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.
authors.affiliation: Department of Cardiology, Children's Memorial Health Institute, Warsaw, Poland. turskakmiec@op.pl
authors.forename: Anna
authors.initials: A
authors.lastname: Turska Kmieć
authors.forename: Maria Katarzyna
authors.initials: MK
authors.lastname: Borszewska Kornacka
authors.forename: Witold
authors.initials: W
authors.lastname: Błaż
authors.forename: Wanda
authors.initials: W
authors.lastname: Kawalec
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Zuk
mesh_terms: D042241:Early Diagnosis; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006330:Heart Defects, Congenital / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D009035:Mothers / Q000523:psychology; D015997:Neonatal Screening / Q000379:methods*; D010092:Oximetry / Q000379:methods*; D011044:Poland / Q000453:epidemiology; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires