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April 2014

Potential—and Potential Pitfalls—of Screening Newborns for Critical Congenital Heart Disease

Author Affiliations
  • 1Department of Pediatrics, University of Washington, Seattle
  • 2Department of Pediatrics, Oregon Health and Science University, Portland
JAMA Pediatr. 2014;168(4):311-312. doi:10.1001/jamapediatrics.2013.5238

Before discharge from a newborn nursery, most US infants undergo screening for a diverse list of medical conditions. In addition to the newborn metabolic screen, recommended screening in each newborn includes testing for hearing loss,1 a serum or transcutaneous measurement of bilirubin level for jaundice,2 and, for infants born at less than 37 weeks’ gestation, a 90-minute “car seat challenge” to evaluate for possible hypoxia.3 The most recent addition to this menu is the recommendation that newborns undergo screening with pulse oximetry for critical congenital heart disease (CCHD) by assessing preductal and postductal oxygen saturation levels before discharge.4 That’s a lot of screening to be completed during a birth hospitalization averaging less than 48 hours for term infants born vaginally.5 In addition, this screening is expected to be accomplished in an atmosphere supportive of maternal-infant bonding and the initiation of successful breastfeeding.

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