{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T20:44:58Z","timestamp":1760647498866,"version":"3.41.2"},"reference-count":22,"publisher":"American Academy of Pediatrics (AAP)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,10,1]]},"abstract":"<jats:sec><jats:title>BACKGROUND AND OBJECTIVES<\/jats:title><jats:p>Conventional timing of newborn pulse oximetry screening is not ideal for infants born out-of-hospital. We implemented a newborn pulse oximetry screen to align with typical midwifery care and measure its efficacy at detecting critical congenital heart disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Cohort study of expectant mothers and infants mainly from the Amish and Mennonite (Plain) communities with limited prenatal ultrasound use. Newborns were screened at 1 to 4 hours of life (\u201cearly screen\u201d) and 24 to 48 hours of life (\u201clate screen\u201d). Newborns were followed up to 6 weeks after delivery to report outcomes. Early screen, late screen, and combined results were analyzed on the basis of strict algorithm interpretation (\u201calgorithm\u201d) and the midwife\u2019s interpretation in the field (\u201cfield\u201d) because these did not correspond in all cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Pulse oximetry screening in 3019 newborns (85% Plain; 50% male; 43% with a prenatal ultrasound) detected critical congenital heart disease in 3 infants. Sensitivity of combined early and late screen was 66.7% (95% confidence interval [CI] 9.4% to 99.2%) for algorithm interpretation and 100% (95% CI 29.2% to 100%) for field interpretation. Positive predictive value was similar for the field interpretation (8.8%; 95% CI 1.9% to 23.7%) and algorithm interpretation (5.4%; 95% CI 0.7% to 18.2%). False-positive rates were \u22641.2% for both algorithm and field interpretations. Other pathologies (noncritical congenital heart disease, pulmonary issues, or infection) were reported in 12 of the false-positive cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Newborn pulse oximetry can be adapted to the out-of-hospital setting without compromising sensitivity or prohibitively increasing false-positive rates.<\/jats:p><\/jats:sec>","DOI":"10.1542\/peds.2020-048785","type":"journal-article","created":{"date-parts":[[2021,9,16]],"date-time":"2021-09-16T08:25:13Z","timestamp":1631780713000},"source":"Crossref","is-referenced-by-count":5,"title":["Newborn Pulse Oximetry for Infants Born Out-of-Hospital"],"prefix":"10.1542","volume":"148","author":[{"given":"Katie B.","family":"Williams","sequence":"first","affiliation":[{"name":"Clinic for Special Children, Strasburg, Pennsylvania"},{"name":"Center for Special Children, Vernon Memorial Healthcare, La Farge, Wisconsin"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Horst","sequence":"additional","affiliation":[{"name":"Lancaster General Health Research Institute, Penn Medicine, Lancaster, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erika A.","family":"Hollinger","sequence":"additional","affiliation":[{"name":"Clinic for Special Children, Strasburg, Pennsylvania"},{"name":"Albright College, Reading, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacob","family":"Freedman","sequence":"additional","affiliation":[{"name":"Clinic for Special Children, Strasburg, Pennsylvania"},{"name":"Franklin & Marshall College, Lancaster, Pennsylvania"},{"name":"Icahn School of Medicine at Mount Sinai, New York, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew M.","family":"Demczko","sequence":"additional","affiliation":[{"name":"Clinic for Special Children, Strasburg, Pennsylvania"},{"name":"Divisions of Diagnostic Referral Services"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Devyani","family":"Chowdhury","sequence":"additional","affiliation":[{"name":"Cardiology Care for Children, Lancaster, Pennsylvania"},{"name":"Cardiology, Nemours Alfred I. duPont Hospital for Children"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2021,10,1]]},"reference":[{"issue":"5","key":"2022010421025356200_B1","doi-asserted-by":"crossref","first-page":"e1502","DOI":"10.1542\/peds.2012-3435","article-title":"Temporal trends in survival among infants with critical congenital heart defects","volume":"131","author":"Oster","year":"2013","journal-title":"Pediatrics"},{"key":"2022010421025356200_B2","doi-asserted-by":"crossref","first-page":"a3037","DOI":"10.1136\/bmj.a3037","article-title":"Impact of pulse oximetry screening on the detection of duct dependent congenital heart disease: a Swedish prospective screening study in 39,821 newborns","volume":"338","author":"de-Wahl Granelli","year":"2009","journal-title":"BMJ"},{"issue":"9793","key":"2022010421025356200_B3","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1016\/S0140-6736(11)60753-8","article-title":"Pulse oximetry screening for congenital heart defects in newborn infants (PulseOx): a test accuracy study","volume":"378","author":"Ewer","year":"2011","journal-title":"Lancet"},{"issue":"3","key":"2022010421025356200_B4","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1016\/j.jpeds.2014.05.011","article-title":"Pulse oximetry screening for critical congenital heart disease in planned out-of-hospital births","volume":"165","author":"Lhost","year":"2014","journal-title":"J Pediatr"},{"key":"2022010421025356200_B5","unstructured":"Centers for Disease Control and Prevention . 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