Audit of pulse oximetry screening for critical congenital heart disease (CCHD) in newborns

OBJECTIVES: To assess the efficacy of a new screening protocol for critical congenital heart disease (CCHD). BACKGROUND: In March 2014, the Ontario Provincial Council for Maternal Child Health (PCMCH) recommended screening for CCHD, utilizing pulse oximetry to measure oxygen saturation as part of the newborn examination. However, this is yet to be implemented in all hospitals. METHOD: An audit of consecutive healthy normal newborn patients in a secondary level centre in Ontario with early adoption of the screening recommendation over a 1-year period was undertaken. RESULTS: The median age of screening was 25 hours (6 to 80 hours). Compliance was 88% (95% if one excludes deliveries by a midwife as they did not agree to comply). Four patients screened positive and were seen by a paediatrician in consultation but did not have CCHD (specificity 99.4%). CONCLUSIONS: The current study shows that screening was successfully implemented in a Canadian hospital, with high specificity (99.4%) and good compliance (88%). Reasons for non-acceptance of screening by midwives need to be addressed.