Evaluation of Pulse Oximetry in the Early Detection of Congenital Heart Diseases in Newborns

Document Type : Original Article


1 Department of Pediatrics, School of Medicine, Social Determinants of Health Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran

2 Student Research Committee, Rafsanjan University of Medical Sciences, Rafsanjan, Iran

3 Department of Pediatrics, School of Medicine, Ali Ibn Abitaleb Educational and Treatment Hospital, Rafanjan University of Medical Sciences, Rafsanjan, Iran

4 Department of Pediatric Nursing, School of Nursing and Midwifery, Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran


Background: Congenital heart diseases, which are asymptomatic at birth, are the most important causes of infant mortality. This study aimed to evaluate the role of pulse oximetry in the early detection of congenital heart diseases among newborns.
Methods: In this cross-sectional descriptive study, 1230 newborns who were born in university hospitals in an urban area of Iran were placed under the pulse oximetry of right hand and right foot. The neonates with peripheral oxygen saturation (SPO2) of less than 95% in the right hand or right foot underwent pulse oximetry of the hands and feet again after two hours. Finally, the newborns with an SPO2 of less than 95% in the second stage were subjected to diagnostic echocardiography. The results were analyzed in SPSS software (version 18). Results: Out of 1230 neonates who underwent pulse oximetry, 417 newborns had an SPO2 of less than 95%, and their SPO2 was rechecked two hours later. Finally, echocardiography was performed for 32 newborns who had an SPO2 of less than 95%, of whom 24 infants were healthy and 8 infants (6 females and 2 males) had congenital heart disease. The sensitivity of the pulse oximetry to detect congenital heart disease was 100%, and its specificity was 98.04%.
Conclusion: The results of this study highlighted the high sensitivity of pulse oximetry in the diagnosis of critical congenital heart disease which can be used at birth.


1. Kliegman RM, Stanton BM, Geme JS, Schor NF. Nelson textbook of pediatrics. 20th ed. New York: Elsevier Health Sciences; 2016.
2. Movahedin AH, Mosayebi Z, Sagheb S. Evaluation of pulse oximetry in the early detection of cyanotic congenital heart diseases in newborns. J Tehran Univ Heart Center. 2016; 11(2):73-8.
3. Acharya G, Sitras V, Maltau JM, Dahl LB, Kaaresen PI, Hanssen TA, et al. Major congenital heart disease in Northern Norway: short comings of pre- and postnatal diagnosis. Acta Obstet Gynecol Scand. 2004; 83(12):1124-9.
4. Aamir T, Kruse L, Ezeakudo O. Delayed diagnosis of critical congenital cardiovascular malformations (CCVM) and pulse oximetry screening of newborns. Acta Paediatr. 2007; 96(8):1146-9.
5. Amaral FT, Manso PH, Schmidt A, Sgarbieri RN, Vicente WV, Carbone Junior C, et al. Recommen-dations for starting a grown up congenital heart disease (GUCH) unit. Rev Bras Cir Cardiovasc. 2015; 30(3):373-9.
6. Ewer AK, Furmston AT, Middleton LJ, Deeks JJ, Daniels JP, Pattison HM, et al. Pulse oximetry as a screening test for congenital heart defects in newborn infants: a test accuracy study with evaluation of acceptability and cost-effectiveness. Health Technol Assess. 2012; 16(2):1-184.
7. Bhola K, Kluckow M, Evans N. Post-implementation review of pulse oximetry screening of well newborns in an Australian tertiary maternity hospital. J Paediatr Child Health. 2014; 50(11):920-5.
8. Abbasi R, Amoozgar H, Keshavarz K, Vafaei F, Ghahramani M, Saeedinegad S, et al. The comparison of pulse oximetry and cardiac catheterization in managing the treatment of children with congenital heart disease. Armaghan Danesh. 2015; 19(12): 1096-104.
9. Valmari P. Should pulse oximetry be used to screen for congenital heart disease? Arch Dis Child Fetal Neonatal Ed. 2007; 92(3):F219-24.
10. Hoke TR, Donohue PK, Bawa PK, Mitchell RD, Pathak 
A, Rowe PC, et al. Oxygen saturation as a screening test for critical congenital heart disease: a preliminary study. Pediatr Cardiol. 2002; 23(4):403-9.
11. Bradshaw EA, Cuzzi S, Kiernam SC. Feasibility of implication pulse oximetry screening for congenital heart disease in a community hospital. J Perinatol. 2012; 32(9):710.
12. Movahedian AH, Noorbaksh SE, Mosayebi Z, Mazoochi T, Moosavi GA. Prevalence of congenital heart disorders in neonates hospitalized in Shahid Beheshti Hospital during the years 1996-2000. Feyz. 2001; 5(2):76-80.
13. Movahedian AH, Mosayebi Z. Prevalence of congenital heart disease in children in Kashan. Sci J Kurdistan Univ Med Sci. 2002; 7(1):17-21.
14. Arlettaz R, Bauschatz AS, Monkhoff M, Essers B, Bauersfeld U. The contribution of pulse oximetry to the early detection of congenital heart disease in newborns. Eur J Pediatr. 2006; 165(2):94-8.
15. Reich JD, Miller S, Brogdon B, Casatelli J, Gompf TC, Huhta JC, et al. The use of pulse oximetry to detect
congenital heart disease. J Pediatr. 2003; 142(3): 268-72.
16. Griebsch I, Knowles RL, Brown J, Bull C, Wren C, Dezateux CA. Comparing the clinical and economic effects of clinical examination, pulse oximetry, and echocardiography in newborn screening for congenital heart defects: a probabilistic cost-effectiveness model and value of information analysis. Int J Technol Assess Health Care. 2007; 23(2):192-204.
17. de-Wahl Granelli A, Wennergren M, Sandberg K, Mellander M, Bejlum C, Inganas L, et al. Impact of pulse oximetry screening on the detection of duct dependent congenital heart disease: a Swedish prospective screening study in 39,821 newborns. BMJ. 2009; 338:a3037.
18. Al Mazrouei SK, Moore J, Ahmed F, Mikula EB, Martin GR. Regional implementation of newborn screening for critical congenital heart disease screening in Abu Dhabi. Pediatr Cardiol. 2013; 34(6):1299-306.