Figure 1
Modified Algorithm Newborn Screening CCHD.
Figure 2
Cohort Profile.
Table 1
Baseline characteristics of newborns screened (N = 1592).
| VARIABLE (N = 1592) | CATEGORY | NUMBER (n) | PERCENTAGE (%) |
|---|---|---|---|
| Sex | Male | 834 | 52.4 |
| Female | 758 | 47.6 | |
| Mode of delivery | Spontaneous vertex delivery | 557 | 35.0 |
| Caesarean section | 1032 | 64.8 | |
| Breech delivery | 03 | 0.80 | |
| Apgar score | 1–4 | 38 | 2.40 |
| 5–8 | 280 | 17.6 | |
| 9–10 | 1274 | 80.0 | |
| Obvious malformations | Yes | 12 | 0.80 |
| no | 1580 | 99.2 | |
| First Screening results | Positive screening | 11 | 0.60 |
| Negative screening | 1573 | 98.9 | |
| Undetermined | 8 | 0.50 |
Table 2
Characteristics of new-borns with positive screen, MNH.
| GESTATION AGE(WEEKS) | MODE OF DELIVERY | ECHO DIAGNOSIS | SATURATION% (R-ARM/LEG) | STATUS AT AGE SIX WEEKS |
|---|---|---|---|---|
| 36 | C-Section | Persistent pulmonary hypertension of newborns | 99%/83% | Patient Died day ten post-delivery with the discharge diagnosis of neonatal Sepsis |
| 35 | C-Section | Normal echocardiography | 89%/93% | Alive, discharged on day 4 |
| 38 | C-Section | Co-arctation of Aorta | 93%/94% | Underwent Successful Neonatal coarctation repair at age 20 days |
| 39 | C-Section | Persistent pulmonary hypertension of newborns & PDA | 92%/88% | Alive discharged on day 3 |
| 37 | SVD | Persistent pulmonary hypertension of newborns & PDA | 93%/97% | Alive discharged on day 10 |
| 40 | SVD | Persistent pulmonary hypertension of newborns | Alive discharged on day 3 | |
| 38 | Breech | Transposition of great arteries | 87%/67% | Alive, underwent successful Rashkind procedure followed by Arterial switch operation on day 10 |
| 38 | SVD | Persistent pulmonary hypertension of newborns | 97%/86% | Alive, discharged on day 4 |
| 38 | SVD | Normal Echo-Sepsis | 88%/92% | Alive, discharged on day 9 |
| 36 | C-Section | Pulmonary Atresia Intact septum | 90%/86% | Alive, underwent B.T. shunt on day 32 |
| 36 | SVD | Ectopic Cordis with DORV | 89%/91% | Died on day 12 from complications of neonatal sepsis |
| 37 | SVD | Died before Echo | 89%/91% | Died before Echo |
| 38 | C-Section | Persistent pulmonary hypertension of newborns | 66%/75% | Alive discharged on day 10 |
| 39 | C-Section | Persistent pulmonary hypertension of newborns | 80%/90% | Alive, discharged on day 9 |
[i] C-section: Caesarean Section, SVD: Spontaneous Vertex Delivery, PDA: Patent Ductus Arteriosus, DORV: Double Outlet Right Ventricle, R-arm: Right arm.
Table 3
Feasibility of the ongoing study.
| ITEM | NUMBER | PERCENTAGE | DESCRIPTION |
|---|---|---|---|
| Number of Providers available for screening vs Trained | 25/30 | 83% | Other trained providers are administrators who are not always available for screening |
| Eligible Newborn | 1,915/2,852 | 67% | Age below 35 weeks and, admission in NICU were the main reasons for non-inclusion |
| Enrolled Newborn | 1,592/1,915 | 83% | 320 new-borns were discharged before age 12 hours, another 3 did not consent |
| False Positive | 10/14 | 71% | Majority (80%) had significant pulmonary conditions |
| Protocol Deviation | 2/10 | 20% | Repeated pulse oximeter at the time of Echocardiogram showed normal saturation. |
| Missed Opportunity | 1/14 | 7% | The Patient died before Echocardiogram could be performed |