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

作者:Tsao Pei Chen; Shiau Yu Shih; Chiang Szu Hui; Ho Hui Chen; Liu Yu Ling; Chung Yuan Fang; Lin Li Ju; Chen Ming Ren; Chang Jia Kan; Soong Wen Jue; Lin Hsiu Lian; Hwang Betau*; Hsiao Kwang Jen*
来源:PLos One, 2016, 11(4): e0153407.
DOI:10.1371/journal.pone.0153407

摘要

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.

  • 出版日期2016-4-13