NEWBORN SCREENING:
PULSE OXIMETRY
Screening for a set of serious,
life-threatening heart defects
known as critical congenital
heart disease (CCHD)
NEWBORN SCREENING: PULSE OXIMETRY
What Is Pulse Oximetry
Screening of Newborns?
• Non-invasive screen
• Estimates % hemoglobin
saturated with oxygen
• Augments current
approaches
• Abnormal screen requires
confirmatory testing
(echocardiography)
NEWBORN SCREENING: PULSE OXIMETRY
BACKGROUND
• 2015 Colorado legislative session
• HB15-1281: Concerning newborn congenital heart
defect screening through the use of pulse oximetry
• Requires all newborns born in a birthing center that
is below an elevation of 7,000 feet to be screened
• Governor signed into law 5/29/2015
NEWBORN SCREENING: PULSE OXIMETRY
PROGRAMATIC IMPACT
• Mandatory screening at facilities below 7,000 feet
• Mandatory reporting of results to CDPHE
• New fields will be added to the electronic birth
reporting system (COVIS) by CDPHE by January 1, 2016
• When the State Board of Health receives confirmation
of appropriate calibration of instruments above 7,000
feet, the board will develop rules for use and reporting
NEWBORN SCREENING: PULSE OXIMETRY
CENTER FOR HEALTH AND ENVIRONMENTAL DATA (CHED)
• COLORADO RESPONDS TO CHILDREN WITH SPECIAL NEEDS
(CRCSN)
• VITAL STATISTICS
•
•
•
•
•
Receive and confirm data
Perform database entry and maintenance
Conduct statistical analysis
Report results
Provide resources and referrals to families
with positive results
NEWBORN SCREENING: PULSE OXIMETRY
CRCSN AND PULSE OX SCREENING
• Evaluate:
• true and false positive screens
• false negative screens
• mortalities
• morbidities
• interventions
• Compare outcomes of children with CCHD
• Assist with economic evaluation of screening
NEWBORN SCREENING: PULSE OXIMETRY
CRCSN AND PULSE OX SCREENING
Valid reviewed and confirmed cases of CCHDs: by year and category (non-isolated).
CCHD Review
Category
2010
2011
Total
Primary
76
73
149
Secondary
78
78
156
Other secondary
4
8
12
Total
158
159
317**
** NOTE: These are total conditions and NOT individual children. These 317 case reports are from 266 Individual
Children. Many of these children have one or more of the conditions that fall into a CCHD review category.
NEWBORN SCREENING: PULSE OXIMETRY
CRCSN CRITERIA FOR CCHD
Selection criteria:
• Live born
• Colorado resident
vital record birth
certificate
identification number
• Statewide
• Date of birth (years):
01/01/2010 through
12/31/2011
Primary CCHD:
1. Common Truncus 7450
2. Transposition of Great
Vessels 74510
3. Tetralogy of
Fallot 7452
4. Pulmonary Valve
Atresia 74601
5. Triscuspid Valve
Atresia 7461 02 (syn)
6. Hypoplastic Left Heart
Syn 7467
7. Total Anomalous
Pulmonary Venous
Return 74741
Secondary CCHD 3/5:
1. Double Outlet Right
Ventricle 74511
2. Coarctation of
Aorta 74710
3. Coarctation
Interruption 7471
NEWBORN SCREENING: PULSE OXIMETRY
OPPORTUNITIES FROM SCREENING
• Baseline occurrence and variations
• Timing of diagnosis
• Mortality
• Sensitivity: false negatives, cases missed by screening
• Specificity: false positives, screen positive without
CCHDs
• Predictive value
• Integration with other areas of public health
NEWBORN SCREENING: PULSE OXIMETRY
303-692-2700
[email protected]
Margaret Ruttenber, MSPH
https://www.colorado.gov/cdphe/monitoring-and-preventing-birth-defects
Data: http://www.chd.dphe.state.co.us/cohid/