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Should we start a nationwide screening program for critical congenital heart disease in Turkey? A pilot study on four centres with different altitudes

  • Dilek Dilli (a1), Vehbi Doğan (a2), Banu M. Özyurt (a3), Abdullah Özyurt (a4), Nilay Hakan (a5), Sibel Bozabalı (a6), İbrahim Caner (a7), Haşim Olgun (a8), Murat Koç (a9), İrfan Taşoğlu (a10), Selmin Karademir (a2) and Ayşegül Zenciroğlu (a1)...

Abstract

Background:

To investigate the feasibility of critical congenital heart disease (CCHD) screening test by pulse oximetry in four geographical regions of Turkey with different altitudes, before implementation of a nationwide screening program.

Methods:

It was a prospective multi-centre study performed in four centres, between December, 2015 and May, 2017. Pre- and post-ductal oxygen saturations and perfusion indices (PI) were measured using Masimo Radical-7 at early postnatal days. The results were evaluated according to the algorithm recommended by the American Academy of Pediatrics. Additionally, a PI value <0.7 was accepted to be significant.

Results:

In 4888 newborns, the mean screening time was 31.5 ± 12.1 hours. At first attempt, the mean values of pre- and post-ductal measurements were: saturation 97.3 ± 1.8%, PI 2.8 ± 2.0, versus saturation 97.7 ± 1.8%, PI 2.3±1.3, respectively. Pre-ductal saturations and PI and post-ductal saturations were the lowest in Centre 4 with the highest altitude. Overall test positivity rate was 0.85% (n = 42). CCHD was detected in six babies (0.12%). Of them, right hand (91 ± 6.3) and foot saturations (92.1 ± 4.3%) were lower compared to ones with non-CCHD and normal variants (p <0.05, for all comparisons). Sensitivity, specificity, positive and negative predictive values, and likelihood ratio of the test were: 83.3%, 99.9%, 11.9%, 99.9%, and 99.2%, respectively.

Conclusion:

This study concluded that pulse oximetry screening is an effective screening tool for congenital heart disease in newborns at different altitudes. We support the implementation of a national screening program with consideration of altitude differences for our country.

Copyright

Corresponding author

Author for correspondence: Dilek Dilli, MD, Associate Professor, Health Science University, Dr Sami Ulus Research and Application Center, Ankara, Turkey. Tel: + 90 312 4123208; Fax: +3124123056013; E- mail: dilekdilli2@yahoo.com

References

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Keywords

Should we start a nationwide screening program for critical congenital heart disease in Turkey? A pilot study on four centres with different altitudes

  • Dilek Dilli (a1), Vehbi Doğan (a2), Banu M. Özyurt (a3), Abdullah Özyurt (a4), Nilay Hakan (a5), Sibel Bozabalı (a6), İbrahim Caner (a7), Haşim Olgun (a8), Murat Koç (a9), İrfan Taşoğlu (a10), Selmin Karademir (a2) and Ayşegül Zenciroğlu (a1)...

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