Document Type : original article
Authors
1 Associate Professor, Division of Neonatology, Department of Paediatrics ,JJM Medical College Davangere, Karnataka
2 Department of Pediatrics,JJM Medical College,Davangere,Karnataka
3 Department of Pediatrics,JJM Medical College,Davangere
Abstract
Objective: To estimate the accuracy of pulse oximetry as a standard screening method to detect congenital heart diseases (CHD) in neonates.
Methods: Pulse oximetry readings were taken of 1603 neonates from right upper limb and either foot with infant breathing room air. Pulse oximetry was considered abnormal if oxygen saturation at room air measured <90% or difference between right hand and foot was more than 3%. Persistent abnormality was considered positive result. Echocardiography was performed on all neonates with positive pulse oximetry and subsequently on neonate with persistent abnormal clinical examination.
Results: Of the term neonates (n=1603) screened, incidence of CHD was 0.7 per 1000 live births and critical CHD was 0.3 per 1000 live births. The sensitivity, specificity, positive predictive value and negative predictive value of pulse oximetry to detect CHD was 70.6%, 98.8%, 38.7% and 99.7%, major CHD was 60%, 98.4%,19.4% and 99.7%, critical CHD was 85.7%, 98.4%, 19.4% and 99.9% respectively. Pulse oximetry had significant positive co-relation with abnormal clinical examination (R=0.29, p<0.001), abnormal colour (R=0.18, p<0.001) and ECHO findings in detecting CHD (R=0.49, p<0.001). Regression model to evaluate whether abnormal clinical examination, cyanosis and positive pulse oximetry are significant predictors of CHD detected by ECHO was statistically significant (R2 =0.34, p value <0.001) and all three were significant independent predictors (p value <0.001).
Conclusion: Pulse oximetry screening is a useful tool for detecting congenital heart diseases in newborns.
Keywords: Congenital heart disease, pulse oximetry, screening, neonate
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