Open AccessDevelopment of a Newborn Screening Program for Critical Congenital Heart Disease (CCHD) in Taipei
Author(s) -
Pei-Chen Tsao,
Yu-Shih Shiau,
SzuHui Chiang,
Henry C. Y. Ho,
Yuling Liu,
YuanChiang Chung,
Lihwai Lin,
MingRen Chen,
JinBiou Chang,
WenJue Soong,
Hsiu-Lian Lin,
Betau Hwang,
KwangJen Hsiao
Publication year - 2016
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0153407
Subject(s) - pulse oximetry , medicine , newborn screening , referral , pediatrics , oxygen saturation , public health , emergency medicine , family medicine , pathology , anesthesia , chemistry , organic chemistry , oxygen
Background Early detection of critical congenital heart disease (CCHD) can significantly reduce morbidity and mortality among newborns. We investigate the feasibility of implementing a community-based newborn CCHD screening program in Taipei. Methods Twelve birthing facilities in Taipei participated in a trial screening program between October 1, 2013, and March 31, 2014. Newborns underwent pulse oximetry at 24–36 h old, with probes attached to the right hand and one lower limb. Any screening saturation ≥95% in either extremity, with an absolute difference of ≤3% between the right hand and foot, was accepted as a screening pass. A screening result was considered as a fail if the oxygen saturation was <95% at either probe site, on 3 separate occasions, each separated by 30 min or the first result was <95% at either probe site, and any subsequent oxygen saturation measurement was <90%. Public health nurses would follow up all missed or refused cases. Results Of the 6,387 live births, 6,296 newborns (coverage rate: 6,296/6,387 = 98.6%) underwent appropriate pulse oximetry screening. Sixteen newborns (0.25%) were reported to have a failed screening result. Five of these screen positive newborns were confirmed with CCHD; two of them were diagnosed solely attributed to the failed screening results. The false-positive rate was 0.18%. Implementing a 6-month screening program for CCHD produced good case detection rate, while using efficient screening and referral systems. Conclusion This program was successful in integrating screening, referral and public health tracking systems. The protocol outlined in this report could provide a community-based model for worldwide implementation.