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Early clinical screening of neonates for congenital heart defects: the cases we miss

Published online by Cambridge University Press:  19 August 2008

Alf Meberg ,
Jan Erik Otterstad ,
Gisle Frøland ,
Jardar Hals  and
Svein Jan Sörland
Alf Meberg*
Affiliation:
Departments of Paediatrics, Vestfold County Central Hospital, N-3116 Tönsberg, Norway
Jan Erik Otterstad
Affiliation:
Departments of Internal Medicine, Vestfold County Central Hospital, N-3116 Tönsberg, Norway
Gisle Frøland
Affiliation:
Departments of Internal Medicine, Vestfold County Central Hospital, N-3116 Tönsberg, Norway
Jardar Hals
Affiliation:
Department of Paediatrics, Buskerud County Central Hospital, Drammen, Norway
Svein Jan Sörland
Affiliation:
Department of Paediatric Cardiology, Rikshospitalet The National Hospital, Oslo, Norway
*
Alf Meberg, MD. Departments ofl Paediatrics, Buskerud County Central Hospital, Drammen, Norway. Tel: 47-33-34-20-00; Fax: 47-33-34-39-63.
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Abstract

In a population-based study of 35,218 infants born alive during the 15 years from 1982 to 1996, 353(1%) were diagnosed as having a congenital heart defect, of whom 84 (24%) were diagnosed subsequent to discharge from hospital after birth (2.4/1000). Of these, 40 (48%) had a ventricular septal defect, 14 (17%) an atrial septal defect, 9 (11%) a patent arterial duct, 8 (10%) an aortic stenosis and 13 (15%) other defects. Compared with those in whom diagnosis was made before discharge, the group of patients with defects detected late had an increased prevalence of atrial septal defects, patent arterial duct and aortic stenosis, but less decreased prevalence of ventricular septal defects (p < 0.05). Median age at detection of the defects subsequent to discharge was 6 months (range 2 weeks–11 years). Seven patients (8%) presented with clinical symptoms of cardiac decompensation. The mortality rate was significantly lower in those in whom defects were detected late (1/84; 1%) as compared with those detected immediately after birth (37/269; 14%) (p < 0.05). The total rate for early detection was the same after using one clinical examination (8.2/1000) of newborns as our basic routine instead of two (7.1/1000) (p > 0.05). A substantial proportion of congenital cardiac malformations are detected after discharge from hospital after birth. Some patients with these lesions present with cardiac decompensation and are in need of medication and surgery. One clinical examination of newborns detects congenital malformations of the heart as efficient as two.

Keywords

Congenital heart defectslate detectionneonatal screening
Type
Original Articles
Information
Cardiology in the Young , Volume 9 , Issue 2 , March 1999 , pp. 169 - 174
Copyright
Copyright © Cambridge University Press 1999

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