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Potential benefits and harms of universal newborn pulse oximetry screening: response to the UK National Screening Committee public consultation
  1. Andrew K Ewer1,2,
  2. Sanjeev A Deshpande3,
  3. Christopher Gale4,5,
  4. Benjamin J Stenson6,7,
  5. Michele Upton8,
  6. Claire Evans9,
  7. Sam J Oddie10,11
  1. 1 Neonatal Medicine, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
  2. 2 Birmingham Women’s and Children’s Hospital, Birmingham, UK
  3. 3 Princess Royal Hospital, Telford, UK
  4. 4 Academic Neonatal Medicine, Imperial College London, London, UK
  5. 5 Chelseaand Westminster NHS Trust, London
  6. 6 Neonatal Unit, Simpson Centre for Reproductive Health, Royal Infirmary of Edinburgh, Edinburgh, UK
  7. 7 RoyalInfirmary of Edinburgh, Edinburgh, UK
  8. 8 NHSImprovement Head of Maternity and Neonatal Transformation Programmes, London, UK
  9. 9 Antenatal and Newborn Screening, Warrington and Halton Hospitals NHS Foundation Trust, Warrington, UK
  10. 10 Centre for Reviews and Dissemination, University of York, York, UK
  11. 11 Bradford Royal Infirmary, Bradford, UK
  1. Correspondence to Professor Andrew K Ewer, Neonatal Unit, Birmingham Womens Hospital, Birmingham B15 2TG, UK; a.k.ewer{at}bham.ac.uk

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Pulse oximetry screening (POS) for critical congenital heart defects (CCHD) has consistent test accuracy,1 meets the criteria for a universal screening test1 and reduces mortality.2

In May 2019, the National Screening Committee (NSC) announced a public consultation on its decision not to introduce routine POS for CCHD in all newborn babies.1

The main reasons given for the NSC’s decision are outlined in the consultation cover note as follows: 

  1. ‘A positive result from pulse oximetry will generate some harms, including parental anxiety, a longer stay in hospital, possible transfer to the neonatal unit (NNU), further tests to assess for non-symptomatic conditions.

  2. For many of these babies, further investigations will be unnecessary and the baby will be identified as healthy. This is a false positive result.

  3. For babies with CHD (congenital heart defects) or other non-cardiac condition, it is not clear that investigations and identification of these conditions will …

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Footnotes

  • Contributors AKE wrote the first draft. All authors edited and approved subsequent drafts.

  • Competing interests AKE was a clinical adviser to the NSC regarding POS and the clinical lead on the PHE pulse oximetry pilot. SAD is Hon. Treasurer, British Association of Perinatal Medicine (BAPM). MU is Patient Safety Lead for NHS England,CE was project lead for the PHE pulse oximetry pilot. SJO is the Clinical Lead for the National Neonatal Audit Project (NNAP).

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Patient consent for publication Not required.

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