Background and aims Studies have shown evidence for universal neonatal screening for critical congenital heart defects (CCHD) with pulse oximetry (PO). However, the feasibility of CCHD screening after homebirth is unknown. We assess the feasibility of PO screening in the Netherlands, where there is a high percentage of homebirths and early discharge after uncomplicated delivery in hospital. Preliminary results of the first 6 months are given.
Methods Since October 2013 a feasibility study is performed in the Leiden region. Pre and post ductal SpO2 are measured ≥1 h after birth in term low-risk infants using Nellcor PO. The measurement is repeated at day 2 or 3. Infants with positive screenings are assessed at the paediatric department and echocardiography is performed in case of persistent abnormal SpO2 readings.
Preliminary results In the study period 1417 infants were born in the Leiden region. Parents of 1093 infants consented for screening and 96% of all infants with parental consent were screened. Inclusion rate increased over time. In 13 infants screening was positive, of which 4 were not recognised and not referred. In 9 positive referred screenings, we detected 1 persistent pulmonary hypertension, 1 muscular ventricular septum defect, 1 patent ductus, 3 infants received sepsis therapy and in 3 infants measurements were normal in hospital. No CCHD was detected and there were no false negative screenings.
Conclusion This is the first pilot study assessing CCHD screening after homebirths and early discharge from hospital. We anticipate to present the final study results at the EAPS.
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