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Multicenter Study
. 2013 Jun;131(6):e1803-10.
doi: 10.1542/peds.2012-3320. Epub 2013 May 20.

Oxygen saturation nomogram in newborns screened for critical congenital heart disease

Affiliations
Multicenter Study

Oxygen saturation nomogram in newborns screened for critical congenital heart disease

Priya Jegatheesan et al. Pediatrics. 2013 Jun.

Abstract

Objective: To establish simultaneous pre- and postductal oxygen saturation nomograms in asymptomatic newborns when screening for critical congenital heart disease (CCHD) at ∼24 hours after birth.

Methods: Asymptomatic term and late preterm newborns admitted to the newborn nursery were screened with simultaneous pre- and postductal oxygen saturation measurements at ∼24 hours after birth. The screening program was implemented in a stepwise fashion in 3 different affiliated institutions. Data were collected prospectively from July 2009 to March 2012 in all 3 centers.

Results: We screened 13 714 healthy newborns at a median age of 25 hours. The mean preductal saturation was 98.29% (95% confidence interval [CI]: 98.27-98.31), median 98%, and mean postductal saturation was 98.57% (95% CI: 98.55-98.60), median 99%. The mean difference between the pre- and postductal saturation was -0.29% (95% CI: -0.31 to -0.27) with P < .00005. Its clinical relevance to CCHD screening remains to be determined. The postductal saturation was equal to preductal saturation in 38% and greater than preductal saturation in 40% of the screens.

Conclusions: We have established simultaneous pre- and postductal oxygen saturation nomograms at ∼24 hours after birth based on >13 000 asymptomatic newborns. Such nomograms are important to optimize screening thresholds and methodology for detecting CCHD.

Keywords: asymptomatic newborns; critical congenital heart disease; oxygen saturation nomogram; oxygen saturation screening; pre- and postductal saturations; pulse oximetry screening; universal screening.

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