Pulse oximetry as a screening tool for detecting Congenital Heart Defects in the West Midlands, United Kingdom – An Interim Analysis

  • Dr Abhay Bhoyar, University of Birmingham, Edgbaston, B15 2TT, Birmingham, UK Cardiology Department, Birmingham Children’s NHS Foundation Trust,, United Kingdom
  • Miss Alexandra Furmston, University of Birmingham, Edgbaston, B15 2TT, Birmingham, UK, United Kingdom
  • Jane Daniels, University of Birmingham, Edgbaston, B15 2TT, Birmingham, UK, United Kingdom
  • Lee Middleton, University of Birmingham, Edgbaston, B15 2TT, Birmingham, UK, United Kingdom
  • Dr John Wright, Cardiology Department, Birmingham Children’s NHS Foundation Trust, Steelhouse Lane, B4 6NH, Birmingham,UK, United Kingdom
  • Prof Khalid Khan, University of Birmingham, Edgbaston, B15 2TT, Birmingham, UK and Birmingham Women's NHS Foundation Trust, Metchley Park Road, E, United Kingdom
  • Dr Andrew Ewer, University of Birmingham, Edgbaston, B15 2TT, Birmingham, UK and Birmingham Women's NHS Foundation Trust, Metchley Park Road, E

    • Objective: To determine the accuracy, psychosocial effects and cost effectiveness of Pulse oximetry (PO) for detecting critical and clinically significant congenital heart disease (CHD) in newborns.


    Design: Population based prospective multicentre delayed cross sectional study in 6 hospitals in the West Midlands. Asymptomatic newborns ≥35 weeks of gestation had PO performed within 24 hours of birth. Low saturations (<95% in either limb or a difference of ≥3% between the limbs) on two separate occasions lead to referral. Echocardiography was performed in all the referrals. Up to one year after completion of recruitment, systematic interrogation of clinical databases will identify all CHD cases in the study population.


    Results: Of the 24657 deliveries from February 2008 to December 2008, 18000 (73 %) babies have been screened. Parental consent was lower amongst the Asian and the Black populations, 80% and 75% respectively Vs White population of >90% (p<0.0001). Of the infants screened, 185 (1.02%) were referred. Thirty four (18.4 %) had CHD, 22 (11.9%) were critical CHD. Pulmonary or other disorders were present in 65 (35.1%). Of the 34 CHD, 11 were antenatally diagnosed. The prevalence of critical and clinically significant CHD in our population was 1.9 per 1000. Final accuracy data will be published on completion of study.


    Conclusion: Pulse oximetry appears to promote early detection of CHD. Our initial experience is encouraging and may support introducing this as a screening tool in the newborn nursery in order to improve the outcome of babies with critical CHD.