title: Results from the New Jersey statewide critical congenital heart defects screening program.
abstract: OBJECTIVE
  New Jersey was the first state to implement legislatively mandated newborn pulse oximetry screening (POxS) in all licensed birthing facilities to detect critical congenital heart defects (CCHDs). The objective of this report was to evaluate implementation of New Jersey's statewide POxS mandate.
  
  
  METHODS
  A 2-pronged approach was used to collect data on infants screened in all New Jersey birthing facilities from August 31, 2011, through May 31, 2012. Aggregate screening results were submitted by each birthing facility. Data on failed screens and clinical characteristics of those newborns were reported to the New Jersey Birth Defects Registry (NJBDR). Three indicators were used to distinguish the added value of mandated POxS from standard clinical care: prenatal congenital heart defect diagnosis, cardiology consultation or echocardiogram indicated or performed before PoxS, or clinical findings at the time of POxS warranting a pulse oximetry measurement.
  
  
  RESULTS
  Of 75,324 live births in licensed New Jersey birthing facilities, 73,320 were eligible for screening, of which 99% were screened. Forty-nine infants with failed POxS were reported to the NJBDR, 30 of whom had diagnostic evaluations solely attributable to the mandated screening. Three of the 30 infants had previously unsuspected CCHDs and 17 had other diagnoses or non-CCHD echocardiogram findings.
  
  
  CONCLUSIONS
  In the first 9 months after implementation, New Jersey achieved a high statewide screening rate and established surveillance mechanisms to evaluate the unique contribution of POxS. The screening mandate identified 3 infants with previously unsuspected CCHDs that otherwise might have resulted in significant morbidity and mortality and also identified other significant secondary targets such as sepsis and pneumonia.
authors.affiliation: Division of Family Health Services, New Jersey Department of Health, PO Box 364, Trenton, NJ 08625-0364, USA. lori.garg@doh.state.nj.us
authors.forename: Lorraine F
authors.initials: LF
authors.lastname: Garg
authors.forename: Kim
authors.initials: K
authors.lastname: Van Naarden Braun
authors.forename: Mary M
authors.initials: MM
authors.lastname: Knapp
authors.forename: Terry M
authors.initials: TM
authors.lastname: Anderson
authors.forename: Robert I
authors.initials: RI
authors.lastname: Koppel
authors.forename: Daniel
authors.initials: D
authors.lastname: Hirsch
authors.forename: Leslie M
authors.initials: LM
authors.lastname: Beres
authors.forename: Joseph
authors.initials: J
authors.lastname: Sweatlock
authors.forename: Richard S
authors.initials: RS
authors.lastname: Olney
authors.forename: Jill
authors.initials: J
authors.lastname: Glidewell
authors.forename: Cynthia F
authors.initials: CF
authors.lastname: Hinton
authors.forename: Alex R
authors.initials: AR
authors.lastname: Kemper
mesh_terms: D002309:Cardiology; D003430:Cross-Sectional Studies; D004452:Echocardiography; D005260:Female; D006284:Health Plan Implementation / Q000331:legislation & jurisprudence; D006330:Heart Defects, Congenital / Q000175:diagnosis* / Q000453:epidemiology*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D015997:Neonatal Screening / Q000331:legislation & jurisprudence*; D009515:New Jersey; D010092:Oximetry; D012017:Referral and Consultation; D012042:Registries
keywords: congenital heart disease/defects; newborn screening; oximetry; surveillance and monitoring