The test is feasible, but the sensitivity and false-positive rate could give a false sense of security.
Diagnosis of congenital heart disease (CHD) in newborns is complicated by the dynamic nature of the transition to extrauterine circulation. Pulse oximetry (PO) has been promoted to enhance early diagnosis of critical heart defects by detecting desaturation and differences in saturation between upper and lower extremities. Investigators prospectively examined the accuracy of PO as a predischarge screening test for CHD in a large cohort (>20,000) of asymptomatic newborns (gestational age, >34 weeks) delivered at six maternity units in the U.K.
PO identified 195 infants with oxygen saturation <95% in either limb or a difference of >2% between upper and lower extremities; 192 of these infants underwent echocardiography. By age 1 year, 24 infants…