Ilona C Narayen1, Nico A Blom2, Marjolein S Bourgonje3, Monique C Haak3, Marrit Smit3, Fennie Posthumus4, Annique J M van den Broek5, Hester M Havers6, Arjan B te Pas7. 1. Department of Neonatology, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: i.c.narayen@lumc.nl. 2. Department of Pediatric Cardiology, Leiden University Medical Center, Leiden, The Netherlands. 3. Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands. 4. Cooperation of Community Midwives in the Leiden Region (LEO), Leiden, The Netherlands. 5. Department of Pediatrics, Alrijne Hospital, Leiden, The Netherlands. 6. Department of Pediatrics, Alrijne Hospital, Leiderdorp, The Netherlands. 7. Department of Neonatology, Leiden University Medical Center, Leiden, The Netherlands.
Abstract
OBJECTIVES: To assess the feasibility of pulse oximetry (PO) screening in settings with home births and very early discharge. We assessed this with an adapted protocol in The Netherlands. STUDY DESIGN: PO screening was performed in the Leiden region in hospitals and by community midwives. Measurements were taken ≥ 1 hour after birth and on day 2 or 3 during the midwife visit. Primary outcome was the percentage of screened infants with parental consent. The time point of screening, oxygen saturation, false positive (FP) screenings, critical congenital heart defects (CCHDs), and other detected pathology were registered. RESULTS: In a 1-year period, 3625 eligible infants were born. Parents of 491 infants were not approached for consent, and 44 refused the screening. PO screening was performed in 3059/3090 (99%) infants with obtained consent. Median (IQR) time points of the first and second screening were 1.8 (1.3-2.8) and 37 (27-47) hours after birth. In 394 infants with screening within 1 hour after birth, the median pre- and postductal oxygen saturations were 99% (98%-100%) and 99% (97%-100%). No CCHD was detected. The FP prevalence was 1.0% overall (0.6% in the first hours after birth). After referral, important noncritical cardiac and other noncardiac pathology was found in 62% of the FP screenings. CONCLUSIONS: PO screening for CCHD is feasible after home births and very early discharge from hospital. Important neonatal pathology was detected at an early stage, potentially increasing the safety of home births and early discharge policy.
OBJECTIVES: To assess the feasibility of pulse oximetry (PO) screening in settings with home births and very early discharge. We assessed this with an adapted protocol in The Netherlands. STUDY DESIGN: PO screening was performed in the Leiden region in hospitals and by community midwives. Measurements were taken ≥ 1 hour after birth and on day 2 or 3 during the midwife visit. Primary outcome was the percentage of screened infants with parental consent. The time point of screening, oxygen saturation, false positive (FP) screenings, critical congenital heart defects (CCHDs), and other detected pathology were registered. RESULTS: In a 1-year period, 3625 eligible infants were born. Parents of 491 infants were not approached for consent, and 44 refused the screening. PO screening was performed in 3059/3090 (99%) infants with obtained consent. Median (IQR) time points of the first and second screening were 1.8 (1.3-2.8) and 37 (27-47) hours after birth. In 394 infants with screening within 1 hour after birth, the median pre- and postductal oxygen saturations were 99% (98%-100%) and 99% (97%-100%). No CCHD was detected. The FP prevalence was 1.0% overall (0.6% in the first hours after birth). After referral, important noncritical cardiac and other noncardiac pathology was found in 62% of the FP screenings. CONCLUSIONS: PO screening for CCHD is feasible after home births and very early discharge from hospital. Important neonatal pathology was detected at an early stage, potentially increasing the safety of home births and early discharge policy.
Authors: Maria N Plana; Javier Zamora; Gautham Suresh; Luis Fernandez-Pineda; Shakila Thangaratinam; Andrew K Ewer Journal: Cochrane Database Syst Rev Date: 2018-03-01
Authors: Ilona C Narayen; Adrian A Kaptein; Janine A Hogewoning; Nico A Blom; Arjan B Te Pas Journal: Eur J Pediatr Date: 2017-03-09 Impact factor: 3.183
Authors: Ilona C Narayen; Estelle E M Mulder; Kim E Boers; Jeroen J van Vonderen; Vera E R A Wolters; Liv M Freeman; Arjan B Te Pas Journal: Front Pediatr Date: 2018-02-12 Impact factor: 3.418