Newborn Screening for Critical Congenital Heart Disease: A New Algorithm and Other Updated Recommendations: Clinical Report

Abstract

Critical congenital heart disease (CCHD) screening was added to the US Recommended Uniform Screening Panel in 2011 and adopted by all US states and territories by 2018. In addition to reviewing key developments in CCHD screening since the initial American Academy of Pediatrics (AAP) endorsement in 2011, this clinical report provides 3 updated recommendations. First, a new AAP algorithm has been endorsed for use in CCHD screening. Compared with the original AAP algorithm from 2011, this new algorithm a) has a passing oxygen saturation threshold of ≥95% in both pre- and post-ductal measurements; and b) has only 1 retest instead of 2 for infants who did not pass the first screen. Second, to continue to improve screening, state newborn screening programs should collect a recommended minimum uniform dataset to aid in surveillance and monitoring of the program. Finally, stakeholders should be educated on the limitations of screening, the significance of non-CCHD conditions, and the importance of protocol adherence. Future directions of CCHD screening include improving overall sensitivity and implementing methods to reduce health inequities. It will remain critical that the AAP and its chapters and members work with health departments and hospitals to achieve awareness and implementation of these recommendations.