Pulse Oximetry Screening for Newborns

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By Mandy Johnson

In 2011, the United States Secretary of Health has recommended the use of pulse oximetry screening in newborns prior to discharge, adding to the universal newborn screening panel to promote early detection of a serious condition known as critical congenital heart disease or CCHD. Today, almost all states in the United States. have applied this recommendation as a standard screening procedure for all newborns in birthing hospitals.

Pulse oximetry is a common procedure that measures the amount of oxygen present in the blood. In newborns, this simple test can be used to keep track of the baby’s oxygen level during a treatment or procedure. It can also help determine the health of the infant’s heart and lungs, but why is this screening test so essential for newborns?

An introduction to critical congenital heart defects

In the United States alone, 18 out of 10,000 babies are born with one of the seven CCHD every year. These seven defects include pulmonary atresia, tetralogy of Fallot, hypoplastic left heart syndrome, total anomalous pulmonary venous return, tricuspid atresia, transposition of great arteries, and truncus arteriosus. Infants are at significant risk for disability or even death if such heart conditions are not diagnosed and treated immediately after birth. This is where a pulse oximetry screening comes into the picture; this routine test can help detect such defects as early as possible.

Importance of CCHD screening

Many infants are born with healthy hearts. However, some may not be as lucky as the others. Prior to delivery, some babies may be diagnosed with a heart defect through an ultrasound, but many of them are not diagnosed until after they come out of the womb, as ultrasound imaging during pregnancy is not capable of detecting all types of congenital heart defects.

Newborn screening, including the application of pulse oximetry, comes into importance as babies born with a congenital heart defect may appear healthy upon delivery and may only develop serious complications days after birth if left untreated. By measuring the baby’s blood oxygen level, a heart defect can be detected at an early stage, making it possible to provide appropriate management to improve the baby’s health.

How newborns are screened with pulse oximetry

Newborn screening is done within 24 to 48 hours from birth. Although pulse oximetry is not officially included in the newborn screening protocol in many states, it is routinely done in medical facilities in some parts of the country. The simple bedside test is done using a pulse oximeter machine and a set of sensors placed on the infant’s skin, which may be a Datex Ohmeda, Nihon Kohden, or a Dinamap.

This procedure is non-invasive, which means that it causes no pain or stress to the baby, and takes only a few minutes. Ideally, a pulse oximetry newborn screening works as a complementary procedure along with a physical examination.

Pulse oximetry results and what they mean

Your baby may be requested for a follow-up testing if the pulse oximetry screening result is out of the normal range, which means that your baby showed low amounts of oxygen in the blood. However, having an out of the range result does not necessarily mean that your baby has a heart defect, as having low pulse oximetry levels can be caused by different factors. But because of the possibility of having the condition, it is important for additional testing to take place as soon as possible.

The doctor may request another screening with pulse oximetry or other more specific tests, such as an electrocardiogram; an echocardiogram, which takes an ultrasound image of the heart; or a chest X-ray to confirm the presence of a CCHD. Complying with these routine screening tests religiously can greatly help improve the outcome of your baby’s health.


Mandy Johnson specializes in Internal Medicine. She has been in the medical field for 8 years now. Aside from having patients, she also enjoys writing medical stuff that helps people to easily understand the nature of her job.

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