Shedding "Light" On Newborn Heart Problems

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WHAT IS CONGENITAL HEART DISEASE? : The seven defects classified as critical congenital heart defects (CCHDs) are hypoplastic left heart syndrome, pulmonary atresia (with intact septum), tetralogy of Fallot, total anomalous pulmonary venous return, transposition of the great arteries, tricuspid atresia, and truncus arteriosus. Babies with one these CCHDs are at significant risk for death or disability if their heart defect is not diagnosed and treated soon after birth. These seven CCHDs among some babies potentially can be detected using pulse oximetry screening, which is a test to determine the amount of oxygen in the blood and pulse rate. Certain hospitals routinely screen all newborns using pulse oximetry screening. However, pulse oximetry screening is not currently included in newborn screening in most states. Other heart defects can be just as severe as these seven CCHDs and also require treatment soon after birth. However, pulse oximetry screening may not detect these heart defects as consistently as the seven disorders listed as CCHDs.  (Source: CDC.gov)

 HOW AND WHEN ARE BABIES SCREENED? : Pulse oximetry is a simple bedside test to determine the amount of oxygen in a baby's blood and the baby's pulse rate. Low levels of oxygen in the blood can be a sign of a CCHD. The test is done using a machine called a pulse oximeter, with sensors placed on the baby's skin. The test is painless and takes only a few minutes. Pulse oximetry screening does not replace a complete history and physical examination, which sometimes can detect a CCHD before oxygen levels in the blood become low.

Pulse oximetry screening, therefore, should be used along with the physical examination. Screening is done when a baby is 24 to 48 hours of age. If the baby is to be discharged from the hospital before he or she is 24 hours of age, screening should be done as late as possible before discharge. Pulse oximetry screening is not currently included in newborn screening in most states. (Source: CDC.gov)

HOW ARE RESULTS MEASURED? : If the results are "negative" (in-range result), it means that the baby's test results did not show signs of a CCHD. This type of screening test does not detect all CCHDs, so it is possible to still have a critical or other heart defect with a negative screening result. If the results are "positive" (out-of-range result), it means that the baby's test results showed low levels of oxygen in the blood. This can be a sign of a CCHD. This does not always mean that the baby has a CCHD. It just means that more testing is needed. The baby's doctor might recommend that the infant get screened again or have more specific tests, like an echocardiogram (an ultrasound picture of the heart), to diagnose a CCHD. Babies who are found to have a CCHD also might be evaluated by a clinical geneticist. This could help identify genetic syndromes associated with these heart defects and inform families about future risks. (Source: CDC.gov)

A WORD FROM THE DOCTOR: Alex Kemper, MD, an Associate Professor Of Pediatrics At Duke University says babies who live in cities with higher elevations – like Denver or Salt Lake City – naturally have lower blood oxygen levels, so states with higher elevations may have to alter their cutoff systems.