Simple blood oxygen test identifies newborns with dangerous heart
13 August 2011
A simple test to measure blood oxygen in newborns has been
shown to identify babies with life-threatening congenital heart defects,
a major cause of infant mortality in the developed world.
The PulseOx study, conducted by researchers from the University
of Birmingham and Birmingham Women’s Hospital, was the largest UK
investigation into screening newborns for congenital heart defects,
which occur in 1 in 160 births in the UK. The results have been
published in The Lancet .
More than 20,000 mothers and babies from throughout the West
Midlands took part in the trial. Midwives used pulse oximetry to
measure oxygen levels in newborns’ blood via a small sensor placed
on the skin of hands or feet. Babies with low oxygen levels soon
after birth may be at increased risk of heart defects.
Current screening for heart defects involves ultrasound before
delivery and routinely examining all newborns in the first 24 hours
after birth. However these examinations often miss babies with
serious heart defects. PulseOx is an additional test which is
carried out on the postnatal ward, before discharge from hospital
and can be life-saving.
Babies who failed the PulseOx test were given a heart ultrasound.
Of 195 babies with an abnormal result following the test, 26 had a
major congenital heart defect and a further 46 had other important
problems which required urgent treatment brought to attention by the
‘It’s usually performed within 24 hours of birth and is simple,
painless and non-invasive,’ explains lead investigator Dr Andrew
Ewer. ‘A small probe is put on the baby’s hand and then on the foot,
the machine is switched on and you obtain a reading. That’s it. It
takes longer to undress the baby than it does to do the test.
‘This study has shown conclusively that this test is
advantageous,’ he goes on. ‘We would like to see all babies being
routinely tested. In this way the test will pick up additional
babies who might otherwise have become very ill or even died. I
think we now have enough evidence to say that pulse oximetry
screening should be incorporated into everyday clinical practice.’
The research was carried out in six NHS trusts: Birmingham
Women’s Hospital, Heart of England NHS Foundation Trust, City
Hospital (Sandwell and West Birmingham NHS Trust.), New Cross
Hospital (the Royal Wolverhampton Hospitals NHS Trust); Royal
Shrewsbury Hospital (the Shrewsbury and Telford Hospitals NHS
Trust); University Hospital of Coventry and Warwickshire.
1. AK Ewer, et al. Pulse oximetry screening for
congenital heart defects in newborn infants (PulseOx): a test
accuracy study. The Lancet, Early Online Publication, 5
August 2011. doi:10.1016/S0140-6736(11)60753-8