CHD Detection at Birth: The Pulse Oximetry Test

Congenital heart disease is the leading cause of infant mortality in the United States, claiming over two times as many lives as all childhood cancers combined. Further, there is evidence that Sudden Infant Death Syndrome (SIDS) may be attributable to undiagnosed CHD in over one-third of SIDS cases.

However, much can be done to improve early detection and the odds of survival and healthy outcomes for many children, with relatively little effort. One such solution is a low-cost, non-invasive screening test that can identify newborns with CHDs.

How the Pulse Ox Test Works

The pulse oximetry test consists of a sensor that detects oxygen saturation levels. By attaching it to various extremities, oxygen saturation levels and discrepancies in oxygen saturation levels can be identified, which can help identify more than 90% of heart defects.

Pulse Ox Test is Not the Standard-of-Care

In 2011, then Secretary of Health and Human Services Kathleen Sebelius recommended that pulse oximetry screening (or “pulse ox” tests) be required for all newborns prior to release from the hospital or birthing facility.

Despite the relatively low cost of pulse ox testing (the American Heart Association estimates just $4), it is still not the standard-of-care. State legislatures are slow to pass laws requiring it, and hospitals may or may not test for oxygen saturation, despite the laws on the books in its state.

For example, it does not appear that even celebrity Jimmy Kimmel’s son was submitted to a pulse oximetry test at the renowned Cedars-Sinai Hospital in Los Angeles, despite the fact that California has required pulse ox testing since 2013.*

*On March 12, 2019, OpHeart received an email from the Associate Director of Media Relations of Cedars-Sinai Hospital, Sally Stewart, stating that preceding sentence “has incorrect and baseless information”.  However, she declined to specify what exactly is inaccurate. Given how Jimmy Kimmel himself described his son’s CHD diagnosis and the relatively high accuracy of the test, unless and until Cedars-Sinai Hospital provides counter-evidence to the statement that “it does not appear that even celebrity Jimmy Kimmel’s son was submitted to a pulse oximetry test”, based on the patient’s father’s own account, that sentence will remain on our website as a powerful and instructive example of the continuing shortcomings in the diagnosis and treatment of CHD.

Ensure That Your Newborn Has a Pulse Ox Test

Before your due date, ask your doctor or midwife whether they administer a pulse ox test as a matter of course for every newborn. If they are unfamiliar with the test or indicate in any way that it is not given to every newborn, insist that your baby get screened, regardless of whether they present any other indications of cardiac distress.

If you would prefer to take matters into your own hands and can afford it, you can purchase a pulse ox test of your own.

Additional Materials

Parade Magazine: Saving the Smallest Hearts: The Test Every Parent Needs to Know About
The $15 Test That Could Save Your Baby’s Life
State Regulations and Hospital Guidelines for Newborn Screening for Critical Congenital Heart Defects