Newborn CHD screening could save 120 infant lives annually

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Takeaway

  • National newborn screening for critical congenital heart disease (CCHD) could save >120 infant lives annually.
  • States requiring screening via pulse oximetry have steepest drops in CCHD-related infant deaths.
  • Only 3 states lack mandatory screening; of these, California requires it to be offered.

Why this matters

  • About 7200 babies born annually in the US have CCHD.
  • An accompanying editorial notes that only Idaho and Wyoming lack mandated CCHD newborn screening.
  • States vary in algorithms they use eg, using both hand and foot vs just a foot.
  • Editorial says that “evidence is now sufficient” that this screening is a “successful public health intervention.”

Key results

  • CCHD-related death rates in states implementing mandated screening dropped from 8.0 (95% CI, 5.4-10.6) per 100,000 births in 2007 to 6.4 (95% CI, 2.9-9.9) per 100,000 births in 2013.
  • Other cardiac-related deaths also fell, from 11.7 (95% CI, 8.6-14.8) per 100,000 births in 2007 to 10.3 (95% CI, 5.9-14.8) per 100,000 births in 2017. 
  • In states without mandatory screening, no significant decreases occurred.

Study design

  • Observational study; 26,546,503 US births through June 30, 2013, National Center for Health Statistics’ period-linked birth/infant death data.
  • Funding: CDC.

Limitations

  • Coding inaccuracies possible; not all confounders necessarily included; critical diagnostic window unclear.