title: Oxygen saturation nomogram in newborns screened for critical congenital heart disease.
abstract: OBJECTIVE
  To establish simultaneous pre- and postductal oxygen saturation nomograms in asymptomatic newborns when screening for critical congenital heart disease (CCHD) at ∼24 hours after birth.
  
  
  METHODS
  Asymptomatic term and late preterm newborns admitted to the newborn nursery were screened with simultaneous pre- and postductal oxygen saturation measurements at ∼24 hours after birth. The screening program was implemented in a stepwise fashion in 3 different affiliated institutions. Data were collected prospectively from July 2009 to March 2012 in all 3 centers.
  
  
  RESULTS
  We screened 13 714 healthy newborns at a median age of 25 hours. The mean preductal saturation was 98.29% (95% confidence interval [CI]: 98.27-98.31), median 98%, and mean postductal saturation was 98.57% (95% CI: 98.55-98.60), median 99%. The mean difference between the pre- and postductal saturation was -0.29% (95% CI: -0.31 to -0.27) with P < .00005. Its clinical relevance to CCHD screening remains to be determined. The postductal saturation was equal to preductal saturation in 38% and greater than preductal saturation in 40% of the screens.
  
  
  CONCLUSIONS
  We have established simultaneous pre- and postductal oxygen saturation nomograms at ∼24 hours after birth based on >13 000 asymptomatic newborns. Such nomograms are important to optimize screening thresholds and methodology for detecting CCHD.
authors.affiliation: Department of Pediatrics, Santa Clara Valley Medical Center, San Jose, CA 95128, USA. priya.jegatheesan@hhs.sccgov.org
authors.forename: Priya
authors.initials: P
authors.lastname: Jegatheesan
authors.forename: Dongli
authors.initials: D
authors.lastname: Song
authors.forename: Cathy
authors.initials: C
authors.lastname: Angell
authors.forename: Kamakshi
authors.initials: K
authors.lastname: Devarajan
authors.forename: Balaji
authors.initials: B
authors.lastname: Govindaswami
mesh_terms: D005260:Female; D006330:Heart Defects, Congenital / Q000175:diagnosis*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D015997:Neonatal Screening / Q000379:methods*; D049451:Nomograms; D010092:Oximetry / Q000379:methods*; D010100:Oxygen
chemical_list: D010100:Oxygen
keywords: asymptomatic newborns; critical congenital heart disease; oxygen saturation nomogram; oxygen saturation screening; pre- and postductal saturations; pulse oximetry screening; universal screening