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. 2016 Apr 13;11(4):e0153407.
doi: 10.1371/journal.pone.0153407. eCollection 2016.

Development of a Newborn Screening Program for Critical Congenital Heart Disease (CCHD) in Taipei

Pei-Chen Tsao  1   2   3   4 , Yu-Shih Shiau  5 , Szu-Hui Chiang  5 , Hui-Chen Ho  6 , Yu-Ling Liu  7 , Yuan-Fang Chung  7 , Li-Ju Lin  7 , Ming-Ren Chen  8 , Jia-Kan Chang  9 , Wen-Jue Soong  1   2 , Hsiu-Lian Lin  7 , Betau Hwang  2   10   11 , Kwang-Jen Hsiao  5   12
Affiliations

Development of a Newborn Screening Program for Critical Congenital Heart Disease (CCHD) in Taipei

Pei-Chen Tsao et al. PLoS One. .

Abstract

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.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. The screening algorithm for CCHD in Taipei.
Abbreviation: critical congenital heart disease, CCHD.
Fig 2
Fig 2. Aggregate pulse oximetry screening results from the 12 birthing facilities for live births.
Total live births: 6,387 (coverage rate: 6,296/6,387 = 98.6%). Abbreviations: pulse oximetry saturation, POxS; right hand, RH; foot, F.
See this image and copyright information in PMC

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