Neonatal screening for life threatening congenital heart disease

doi:10.1136/bmj.a2663

Published 8 January 2009, doi:10.1136/bmj.a2663
Cite this as: BMJ 2009;338:a2663

Editorials

Neonatal screening for life threatening congenital heart disease

Routine pulse oximetry is an effective and low risk strategy

The first 150 words of the full text of this article appear below.

The linked study by de-Wahl Granelli and colleagues (doi:10.1136/bmj.a3037)assesses the contribution of neonatal pulse oximetry saturationscreening to early detection of life threatening congenitalheart disease.¹ Neonatal screening started in the 1960s withthe Guthrie bacterial inhibition test for detection of phenylketonuria.²Screening for this rare condition (about 1/12 000 live births)is almost universal in the developed world, and it illustratesthe criteria for such a programme. Phenylketonuria can be reliablyidentified when asymptomatic, with a low false positive rate,and when treated early death or disability are prevented. Newerscreening tests using techniques other than blood sampling shouldfollow the same principles.

Critical congenital heart disease—cardiac malformationsthat are either ductal dependent or need surgery in the firstmonth of life—occurs in about 170 per 100 000 live births.At first sight, universal pulse oximetry screening for thisdisease seems to contravene the above principles . . . [Full text of this article]

Keith J Barrington, professor of pediatrics

¹ Université de Montréal, Sainte Justine Hospital, Montréal, Québec Canada, H3T 1C5

keith.barrington@mcgill.ca

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Impact of pulse oximetry screening on the detection of duct dependent congenital heart disease: a Swedish prospective screening study in 39 821 newborns: Anne de-Wahl Granelli, Margareta Wennergren, Kenneth Sandberg, Mats Mellander, Carina Bejlum, Leif Inganäs, Monica Eriksson, Niklas Segerdahl, Annelie Ågren, Britt-Marie Ekman-Joelsson, Jan Sunnegårdh, Mario Verdicchio, and Ingegerd Östman-Smith
BMJ 2009 338: a3037. [Abstract] [Full Text] [PDF]