Performance of pulse oximetry screening for detection of congenital heart diseases in neonates at two health facilities in Yaounde, Cameroon
Keywords:
Pulse oximetry, congenital heart disease, neonatal screening, CameroonAbstract
Background: Early detection of congenital heart diseases (CHD) remains challenging in resource-limited settings. This study aimed to determine the diagnostic performance of pulse oximetry screening in detecting congenital heart diseases in neonates.
Methods: This was a test validity study conducted over 8 months at two referral hospitals in Yaoundé. Newborns with gestational age >35 weeks underwent pulse oximetry screening after 24 hours of life. Oxygen saturation (SpO₂) was measured at four limbs to determine whether there is a difference in saturation between the upper and lower limbs. The test was considered positive if SpO₂ <95% or if the difference between preductal (right hand) and post-ductal (lower limb) measurements >3%. All newborns subsequently underwent echocardiography.
Results: Fifty newborns were included in the study. The prevalence of CHD as 22% (11/50). Among newborns with SpO₂ <95%, 6 out of 7 had CHD confirmed by echocardiography. The identified cardiac malformations included atrial septal defects (n=2), ventricular septal defect (n=1), atrioventricular canal defect (n=1), bicuspid aortic valve (n=3), pulmonary valve stenosis (n=3), and combined pulmonary valve stenosis with bicuspid aortic valve (n=1). Pulse oximetry demonstrated a sensitivity of 54.54%, specificity of 97.43%, positive predictive value of 85.71%, and negative predictive value of 83.37%. There was a statistically significant relationship between oxygen saturation <95% and the presence of CHD (OR 20.5, 95% CI: 5.30-79.21; p<0.001).
Conclusion: Pulse oximetry is a valuable, non-invasive screening tool for detecting CHD in neonates. Its high specificity and positive predictive value support its systematic implementation in resource- limited settings to improve early diagnosis and management of CHD.
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