Diagnostic Tests and Screenings

Newborn pulse oximetry screening for early detection of critical congenital heart disease.

Congenital heart disease (CHD) is the most common birth defect in children, afflicting nearly 1 in every 100 newborns. Timely diagnosis and treatment are crucial to providing the best opportunity for good outcomes.  In the fall of 2011, universal pulse oximetry screening of newborns was recommended by the American Academy of Pediatrics, the American College of Cardiology, the American Heart Association and the Department of Health and Human Services. The Michigan Department of Community Health (MDCH) will begin requiring pulse oximetry screening for all newborns beginning April 1, 2014. C.S. Mott Children’s Hospital has partnered together with the State of Michigan Department of Community Health and other institutions throughout the State to implement routine newborn screening for critical congenital heart disease for all babies born in Michigan.  

Why is pulse oximetry screening important?

Early detection of critical congenital heart disease can lead to earlier intervention and improved quality of life. Newborn screening can prevent morbidity and mortality associated with unrecognized critical congenital heart disease.  Newborn pulse oximetry is a simple, non-invasive and effective tool for assessing the level of oxygen in the blood. It can be used for screening to increase early detection of many critical congenital heart defects and improve outcomes.  The goal of implementing routine pulse oximetry screening for all newborns is to detect congenital heart defects before a newborn is discharged from the hospital. 

What are the pulse oximetry screening recommendations for newborns?

It is recommended that all newborns are screened around 24 hours of age, or as close as possible to discharge if the newborn is discharged prior to 24 hours of age.

What happens when a baby fails a pulse oximetry screening?

When a baby fails a pulse oximetry screening, this is not a definitive diagnosis of critical congenital heart disease. Oxygen saturation can be low for a number of reasons. Failed screening should be considered an alert that further evaluation is needed to explore the variables that may have contributed to the failed screening. 

What resources are available to support programs performing newborn screening for critical congenital heart disease?

C.S. Mott Children’s Hospital is committed to assisting birthing centers, families, health care providers, and emergency departments (some babies who pass the newborn screen may present later with critical congenital heart defects). Learn more about our Congenital Heart Center.

  • For clinical assistance in differentiating the diagnosis of a baby with an abnormal pulse oximetry screening or other symptoms of heart disease, University of Michigan specialists are readily available around the clock to provide telephone, echocardiogram and electrocardiogram interpretation, and, if necessary, facilitate transfers for further evaluation and care. For professional consultation at any time, contact University of Michigan Health System M-LINE at 800-962-3555.
  • U-M pediatric cardiologists are available to speak at Pediatric Grand Rounds or other educational conferences at your institution. For more information, please contact our Clinical Outreach Specialist at gfosse@med.umich.edu or 616.402.5246.

Michigan Department of Community Health has created additional resources for educating professionals and families about critical congenital heart disease screening for newborns.