4.7 Article

Newborn Pulse Oximetry for Infants Born Out-of-Hospital

Journal

PEDIATRICS
Volume 148, Issue 4, Pages -

Publisher

AMER ACAD PEDIATRICS
DOI: 10.1542/peds.2020-048785

Keywords

-

Categories

Funding

  1. Abigail L. Longenecker Memorial Foundation
  2. Ronald McDonald House Charities
  3. Hershey Rotary
  4. Pennsylvania Department of Health

Ask authors/readers for more resources

This study investigated the effectiveness of newborn pulse oximetry screening in out-of-hospital settings and found that it can be adapted without compromising sensitivity or significantly increasing false-positive rates.
BACKGROUND AND OBJECTIVES: Conventional timing of newborn pulse oximetry screening is not ideal abstract for infants born out-of-hospital. We implemented a newborn pulse oximetry screen to align with typical midwifery care and measure its efficacy at detecting critical congenital heart disease. METHODS: Cohort study of expectant mothers and infants mainly from the Amish and Mennonite (Plain) communities with limited prenatal ultrasound use. Newborns were screened at 1 to 4 hours of life (early screen) and 24 to 48 hours of life (late screen). Newborns were followed up to 6 weeks after delivery to report outcomes. Early screen, late screen, and combined results were analyzed on the basis of strict algorithm interpretation (algorithm) and the midwife's interpretation in the field (field) because these did not correspond in all cases. RESULTS: Pulse oximetry screening in 3019 new borns (85% Plain; 50% male; 43% with a prenatal ultrasound) detected critical congenital heart disease in 3 infants. Sensitivity of combined early and late screen was 66.7% (95% confidence interval [CI] 9.4% to 99.2%) for algorithm interpretation and 100% (95% CI 29.2% to 100%) for field interpretation. Positive predictive value was similar for the field interpretation (8.8%; 95% CI 1.9% to 23.7%) and algorithm interpretation (5.4%; 95% CI 0.7% to 18.2%). False-positive rates were <= 1.2% for both algorithm and field interpretations. Other pathologies (noncritical congenital heart disease, pulmonary issues, or infection) were reported in 12 of the false-positive cases. CONCLUSIONS: Newborn pulse oximetry can be adapted to the out-of-hospital setting without compromising sensitivity or prohibitively increasing false-positive rates.

Authors

I am an author on this paper
Click your name to claim this paper and add it to your profile.

Reviews

Primary Rating

4.7
Not enough ratings

Secondary Ratings

Novelty
-
Significance
-
Scientific rigor
-
Rate this paper

Recommended

No Data Available
No Data Available