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. 2013 Aug;132(2):e314-23.
doi: 10.1542/peds.2013-0269. Epub 2013 Jul 15.

Results from the New Jersey statewide critical congenital heart defects screening program

Lorraine F Garg  1 , Kim Van Naarden Braun, Mary M Knapp, Terry M Anderson, Robert I Koppel, Daniel Hirsch, Leslie M Beres, Joseph Sweatlock, Richard S Olney, Jill Glidewell, Cynthia F Hinton, Alex R Kemper
Affiliations

Results from the New Jersey statewide critical congenital heart defects screening program

Lorraine F Garg et al. Pediatrics. 2013 Aug.

Abstract

Background and objective: New Jersey was the first state to implement legislatively mandated newborn pulse oximetry screening (POxS) in all licensed birthing facilities to detect critical congenital heart defects (CCHDs). The objective of this report was to evaluate implementation of New Jersey's statewide POxS mandate.

Methods: A 2-pronged approach was used to collect data on infants screened in all New Jersey birthing facilities from August 31, 2011, through May 31, 2012. Aggregate screening results were submitted by each birthing facility. Data on failed screens and clinical characteristics of those newborns were reported to the New Jersey Birth Defects Registry (NJBDR). Three indicators were used to distinguish the added value of mandated POxS from standard clinical care: prenatal congenital heart defect diagnosis, cardiology consultation or echocardiogram indicated or performed before PoxS, or clinical findings at the time of POxS warranting a pulse oximetry measurement.

Results: Of 75,324 live births in licensed New Jersey birthing facilities, 73,320 were eligible for screening, of which 99% were screened. Forty-nine infants with failed POxS were reported to the NJBDR, 30 of whom had diagnostic evaluations solely attributable to the mandated screening. Three of the 30 infants had previously unsuspected CCHDs and 17 had other diagnoses or non-CCHD echocardiogram findings.

Conclusions: In the first 9 months after implementation, New Jersey achieved a high statewide screening rate and established surveillance mechanisms to evaluate the unique contribution of POxS. The screening mandate identified 3 infants with previously unsuspected CCHDs that otherwise might have resulted in significant morbidity and mortality and also identified other significant secondary targets such as sepsis and pneumonia.

Keywords: congenital heart disease/defects; newborn screening; oximetry; surveillance and monitoring.

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Figures

FIGURE 1
FIGURE 1
Aggregate pulse oximetry screening results from all licensed New Jersey birthing facilities for live births from August 31, 2011, to May 31, 2012. aReported reason for having not been screened. NJ, New Jersey.
FIGURE 2
FIGURE 2
Failed pulse oximetry screens reported to the New Jersey Birth Defects Registry for New Jersey–resident live births screened from August 31, 2011, to May 31, 2012.
See this image and copyright information in PMC

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