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PLoS One. 2016 Apr 13;11(4):e0153407. doi: 10.1371/journal.pone.0153407. eCollection 2016.

Development of a Newborn Screening Program for Critical Congenital Heart Disease (CCHD) in Taipei.

Author information

1
Division of General Pediatrics, Pediatrics Department, Taipei Veterans General Hospital, Taipei, Taiwan.
2
Department of Pediatrics, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
3
Institute of Physiology, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
4
Institute of Emergency and Critical Care Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
5
Preventive Medicine Foundation, Taipei, Taiwan.
6
Taipei Institute of Pathology, Taipei, Taiwan.
7
Department of Health, Taipei City Government, Taipei, Taiwan.
8
MacKay Children's Hospital, Taipei, Taiwan.
9
Pediatrics Department, Cheng Hsin General Hospital, Taipei, Taiwan.
10
Taipei City Hospital, Zhongxiao Branch, Taipei, Taiwan.
11
Cardiac Medical Center, Tung's Taichung Metroharbor Hospital, Taichung, Taiwan.
12
Department of Education and Research, Taipei City Hospital, Taipei, Taiwan.

Abstract

BACKGROUND:

Early detection of critical congenital heart disease (CCHD) can significantly reduce morbidity and mortality among newborns. We investigate the feasibility of implementing a community-based newborn CCHD screening program in Taipei.

METHODS:

Twelve birthing facilities in Taipei participated in a trial screening program between October 1, 2013, and March 31, 2014. Newborns underwent pulse oximetry at 24-36 h old, with probes attached to the right hand and one lower limb. Any screening saturation ≥95% in either extremity, with an absolute difference of ≤3% between the right hand and foot, was accepted as a screening pass. A screening result was considered as a fail if the oxygen saturation was <95% at either probe site, on 3 separate occasions, each separated by 30 min or the first result was <95% at either probe site, and any subsequent oxygen saturation measurement was <90%. Public health nurses would follow up all missed or refused cases.

RESULTS:

Of the 6,387 live births, 6,296 newborns (coverage rate: 6,296/6,387 = 98.6%) underwent appropriate pulse oximetry screening. Sixteen newborns (0.25%) were reported to have a failed screening result. Five of these screen positive newborns were confirmed with CCHD; two of them were diagnosed solely attributed to the failed screening results. The false-positive rate was 0.18%. Implementing a 6-month screening program for CCHD produced good case detection rate, while using efficient screening and referral systems.

CONCLUSION:

This program was successful in integrating screening, referral and public health tracking systems. The protocol outlined in this report could provide a community-based model for worldwide implementation.

PMID:
27073996
PMCID:
PMC4830600
DOI:
10.1371/journal.pone.0153407
[Indexed for MEDLINE]
Free PMC Article

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