Screening for heart defects

A simple test to measure blood oxygen in newborns has been shown to identify babies with life-threatening congenital heart defects, a major cause of infant mortality in the developed world. Research from the University and Birmingham Women’s Hospital has now been published in the Lancet.

The PulseOx study is the largest UK investigation into screening newborns for congenital heart defects, which occur in 1 in 160 births in the UK. More than 20,000 mothers and babies from throughout the West Midlands took part in the trial. Midwives used pulse oximetry to measure oxygen levels in newborns’ blood via a small sensor placed on the skin of hands or feet. Babies with low oxygen levels soon after birth may be at increased risk of heart defects.

Current screening for heart defects involves ultrasound before delivery and routinely examining all newborns in the first 24 hours after birth. However these examinations often miss babies with serious heart defects. PulseOx is an additional test which is carried out on the postnatal ward, before discharge from hospital and can be life-saving.

Babies who failed the PulseOx test were given a heart ultrasound. Of 195 babies with an abnormal result following the test, 26 had a major congenital heart defect and a further 46 had other important problems which required urgent treatment brought to attention by the test.

‘It’s usually performed within 24 hours of birth and is simple, painless and non-invasive,’ explains lead investigator Dr Andrew Ewer. ‘A small probe is put on the baby’s hand and then on the foot, the machine is switched on and you obtain a reading. That’s it. It takes longer to undress the baby than it does to do the test.

‘This study has shown conclusively that this test is advantageous,’ he goes on. ‘We would like to see all babies being routinely tested. In this way the test will pick up additional babies who might otherwise have become very ill or even died. I think we now have enough evidence to say that pulse oximetry screening should be incorporated into everyday clinical practice.’

The research was carried out in six NHS trusts covering an area including Birmingham, Wolverhampton, Warwickshire and Shropshire.

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