The United States, Singapore, Vietnam, Argentina, and other countries are set to support compulsory pulse oximetry (SpO2) screening of newborns for duct dependent congenital heart disease (CHD) before leaving hospital.

The decisions are being based on the findings of the now famous “Swedish study,” published in January 2009 in BMJ, which showed that mortality among infants discharged with an undiagnosed critical heart defect was 18%, or around one in six children, but only 0.9% for those diagnosed using SpO2 before leaving hospital. As a result, several counties in Sweden have already introduced the test, although as yet there is no coordinated national recommendation. Additionally, all newborns in Beijing (China) are already being screened, and other countries are set to make the test mandatory.

The researchers at the University of Gothenburg (Sweden), and Queen Silvia Children's Hospital (Göteborg, Sweden) conducted their study between 2004 and 2009, performing a pulse oximetry test before discharge from well baby nurseries in the district of West Götaland. The cohort study compared the detection rate of duct dependent circulation in the district with that in other regions that are not using pulse oximetry screening. The results showed that no baby died from undiagnosed duct dependent circulation in West Götaland, versus five deaths babies from the other referring regions.

“People around the world are now talking about `the Swedish study,´ and I've been invited to Nanjing in China to help start up a screening program there this autumn,” said the study’s lead author Anne de-Wahl Granelli, MD. “I'm absolutely delighted that the research has had such an impact. My colleagues and everyone else who helped us with the clinical side of the study over a three-and-a-half-year period all deserve a share of the credit for the attention it has been given worldwide.”

Pulse oximetry is a noninvasive test that is applied to the right hand and a foot of a newborn, to get two different readings of oxygen levels in the blood. Testing should ideally be done after the baby is 24 hours old, since changes in the circulatory system during very early in life can cause a false positive result. A low SpO2 level can result from CHD, infections, or other serious health problems. Congenital heart diseases are responsible for more deaths in the first year of life than any other birth defect, but outcomes can often be improved with early detection.

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