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British researchers demonstrated that a routine screening test for all newborn babies could improve the diagnosis of congenital heart defects.
The study shows that using pulse oximetry, or pulseox, which uses an infrared sensor to detect the level of oxygen in the blood in a baby’s fingers or toes, may help physicians screen for heart problems and identify those babies with health problems that might have gone undetected. The work assessed the accuracy of pulse oximetry as a screening test for congenital heart defects.
Typically, these sorts of screenings rely on antenatal ultrasonography and postnatal clinical examination. However, the researchers found that life-threatening defects can remain undetected using these methods alone.
A total of 20,055 newborns were screened. Among those babies found to have a sub-par oxygen-saturation screening result, the test was repeated. If they were found to have a test below the threshold, the baby was given an echocardiogram for further diagnosis.
The study found that 99% of babies without a major heart defect were correctly identified as healthy. Twenty-five babies screened were falsely identified as being healthy. Researchers say that this screening provides a better level of sensitivity than using the current diagnostic methods of antenatal ultrasound and clinical examination alone.
“Pulse oximetry is a safe, feasible test that adds value to existing screening,” stated the researchers in The Lancet. “It identifies cases of critical congenital heart defects that go undetected with antenatal ultrasonography. The early detection of other diseases is an additional advantage.”
Pulseox is inexpensive and non-invasive, but whether using it for screening will indeed save infants’ lives has yet to be fully determined. Physicians also need to determine how such screenings might fit with others types of health screenings conducted immediately after birth.
The National Health Service says that although it remains uncertain “whether this technique will improve clinical outcomes in babies, these positive results mark it out as a strong candidate for further trial and discussion.” The agency adds that “although the study’s findings have positive implications, this research cannot prove that screening using pulse oximetry would save lives. That said, it does demonstrate potential for the use of the technique, and supports the case for conducting a randomised controlled trial comparing pulse oximetry against other forms of screening or no screening at all.”
The study was conducted by researchers from University of Birmingham and University of London, Barts, and the London School of Medicine; and was published in the peer-reviewed medical journal, The Lancet.
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Linda Dailey Paulson is a professional journalist who has been covering medical and technology stories for over two decades.