Thursday, March 14, 2013

Congenital Heart Defect Screening Saves Newborn Lives

New legislation before state lawmakers would screen infants for congenital heart diseases before they leave the hospital. Texas physicians support the legislation because screening for heart diseases can lead to earlier detection and diagnosis and in turn save an infant’s life. Rep. Myra Crownover (R-Denton) is carrying the bill.

By Alice Gong, MD
Professor of Pediatrics
The University of Texas Health Science Center at San Antonio

Congenital heart defects are the most common birth defect, affecting about 40,000 newborns each year in the United States. About 25 percent of congenital heart defects are known as critical congenital heart disease (CCHD). These can cause serious, life-threatening symptoms and require medical attention within the first days or first year of life.

Newborn screening using a pulse oximeter (a device that measures oxygen levels in the blood) can identify some infants with CCHD. These structural heart defects are often associated with low levels of oxygen in the blood, known as hypoxia, when a baby is still a newborn. Infants with CCHDs are at risk for serious health issues, even death, early in life due to severe defects of the heart, including abnormal or absent chambers, holes in the heart, abnormal connections in the heart, and abnormalities in the function or squeeze of the heart. Newborn screening with pulse oximetry can detect seven defects that cause CCHD. These seven CCHDs represent about 17-31 percent of all congenital heart disease. All of these defects require some type of intervention, often a surgical procedure, soon after birth.

In September 2011, CCHD was added to the Recommended Uniform Screening Panel for newborns endorsed by the American Academy of Pediatrics, American Heart Association, and American College of Cardiologists. Many states have added CCHD screening to their list of newborn screens.

Texas soon may require the screening. Texas legislators recognize the importance of screening for critical congenital heart disease and have introduced legislation to ensure all newborns are screened.

The Texas Pulse Oximetry Project (TxPOP) is a Department of State Health Services-funded education project to encourage screening of critical congenital heart disease using pulse oximetry. Beginning in July 2012, The University of Texas Health Science Center at San Antonio and Baylor College of Medicine, in conjunction with Texas Children’s Hospital, received grant money through the project to provide training for nurses, physicians, and other health care professionals at delivering hospitals in Texas on CCHD newborn screening using pulse oximetry.

Shortly after the education phase of the grant, pulse oximetry screening saved a newborn’s life. An apparently healthy baby boy was screened after 24 hours of life before he left the newborn nursery. He was found to have a critical congenital heart defect and underwent a successful corrective surgery.

Dr. Gong is a neonatologist and pediatrician in San Antonio.

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