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Experts Recommend Screening Newborns for Heart Defects

An expert panel recommends infants be screened for critical heart problems using a simple, non-invasive test called pulse oximetry.

Simple, inexpensive test can identify rare but serious conditions

One of the scariest things a new parent can hear is, “your baby has a birth defect.” But some of the most dangerous birth defects are are invisible ones, such as deformities in the baby's tiny heart.

Now, a group of U.S. experts is recommending that all newborns get a simple, inexpensive screening for critical heart defects.

Congenital heart disease affects only about one birth out of 120 in the United States, and only a fraction of those are considered critical. But given the number of babies born each year, it adds up.

About three-quarters of critical heart defects can be identified by routine tests already in use, "but unfortunately there are still cases that can slip through," says Duke University pediatrician Alex Kemper. "And the challenge is that it can be almost impossible to identify some of these cases. These are babies that otherwise look totally normal and like every other baby in the nursery."

Kemper is a member of the expert panel that is recommending infants be screened for critical heart problems using a simple, non-invasive test called pulse oximetry.

The idea is to measure the oxygen level in the blood. Low oxygen levels may signal a problem with the heart.

The test measures oxygen levels indirectly, by shining certain wavelengths of light through a foot or finger onto a sensor on the other side.

Kemper says it's important to identify kids with these critical heart problems early on in life.

"Because these are conditions that really need early intervention in that if you were to discharge some of these children without providing any medical care, they could go home and even die."

Although pulse oximetry screening is easy and cheap, the hard part comes when an infant is identified with a potential heart defect. More advanced testing is then needed, and even in a wealthy country like the United States, not all hospitals can provide those services.

So does the screening make sense in more resource-poor areas? Kemper says yes, because it can identify some hidden problems that may not require expensive, high-tech treatments.

"Anything that causes low oxygen levels in the blood would test positive. And so, there are potential other spillover effects including identifying important infections."

The recommendations of the expert workgroup, including Duke University's Alex Kemper, on screening newborns for heart defects is published online by the journal Pediatrics.