{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,3]],"date-time":"2026-01-03T21:09:19Z","timestamp":1767474559697,"version":"3.40.5"},"reference-count":30,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,8,6]],"date-time":"2023-08-06T00:00:00Z","timestamp":1691280000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Paediatrica"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Our aim was to assess undiagnosed congenital heart defects (CHD) after newborns' hospital discharge in patients with a murmur or CHD suspicion, to find out the signs that predict CHDs and to estimate the costs of the examinations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We reviewed retrospective medical records of patients (n\u2009=\u2009490) referred for the evaluation of CHD suspicion during 2017\u20132018.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median age of the patients was 2.5 (IQR 0.5\u20137.4) years. Sixty\u2010three (13%) patients had an abnormal echocardiography. Neither ductal\u2010dependent nor cyanotic CHDs were found. Cardiac interventions were performed for 14 out of 63 (22%) patients. Clinical signs indicating CHDs were murmur grade \u22653 (10\/11 [91%] vs. 53\/479 [11%], <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and harsh murmur (15\/44 [34%] vs. 48\/446 [11%], <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Abnormal electrocardiography did not indicate CHD (8\/40 [20%] vs. 55\/447 [12%], <jats:italic>p<\/jats:italic>\u2009=\u20090.165). The total cost of the examinations was 259\u2009700\u20ac. The share of the cost of studies assessed as benign was 59%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Only a few CHDs were found after newborn hospital discharge among patients who received foetal and newborn screening and were examined due to CHD suspicion. The high number of benign murmurs in children leads to many referrals, resulting in unnecessary healthcare costs.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apa.16928","type":"journal-article","created":{"date-parts":[[2023,7,31]],"date-time":"2023-07-31T11:48:57Z","timestamp":1690804137000},"page":"143-149","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Major congenital heart defects are rarely diagnosed after newborns' hospital discharge with modern screening"],"prefix":"10.1111","volume":"113","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0938-5053","authenticated-orcid":false,"given":"I.","family":"Papunen","sequence":"first","affiliation":[{"name":"Tampere Center for Child, Faculty of Medicine and Health Technology, Adolescent and Maternal Health Research Tampere University  Tampere 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