Title: Newborn Screening for CCHD
Headings: ​​​Program to Enhance the Health & Development of Infants and Children (PEHDIC)​
​​​Program to Enhance the Health & Development of Infants and Children (PEHDIC)​
Newborn Screening: Critical Congenital Heart Defects
Answ​ers and Resources for Primary Care Pediatricians
Frequently Asked Questions
Topic 1: Rationale for CCHD Screening​
​​Topic 2: Implementation of CCHD​
​​​Topic 3: CCHD Screening Data Collection and Management​​​
​Topic 4: Screening in Special Settings​​​
​Ask a CCHD Implementation question​
Resources
State Implementation
References
Related AAP Policy Statements

Content: The AAP recommends that all newborns ​be screened for CCHD,​ regardless of whether they live in a state that includes CCHD screening within their newborn screening program. ​
If an asymptomatic infant fails their pulse-oximetry screening, what is the likelihood that CCHD or some other serious disease is present? In the Swedish study​ on which the recommended pulse-oximetry screening protocol is based, 25% of babies with a failed screen had CCHD, 47% had another disease process such as pulmonary pathology or sepsis, and 28% were well. Published data from New Jersey demonstrates that in asymptomatic babies with a failed CCHD screen, 10% had CCHD, 23% had another disease process causing hypoxemia, and 67% had non-critical congenital heart defect or were well. The differences between these two studies may be in part related to age at screening and a much higher prenatal detection rate of CCHD in New Jersey than in Sweden. Overall, the false positive rate is very low​. It is important to recognize that a baby with a failed screen can look completely well on exam but have a significant underlying medical problem. Won’t CCHD be detected prenatally or by my exam in the nursery? Maybe not. Prenatal ultrasounds can detect fewer than half of the cases of CCHD and predicting saturations based on visual examination of color is unreliable. Prior to discharge, some babies with CCHD will have normal exams and not appear cyanotic.