{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T06:14:06Z","timestamp":1788502446190,"version":"build-2803163510"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Critical congenital heart disease (CCHD) is a leading cause of neonatal morbidity and mortality. Early detection is crucial to prevent life-threatening complications. Pulse oximetry screening (POS) is a noninvasive method to identify hypoxemia indicative of CCHD, but the optimal timing for screening remains debated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>To evaluate the diagnostic accuracy of dual POS performed at 24\u201336 h and 48\u201372 h of life for early detection of CCHD in neonates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This prospective observational study was conducted over 20 months at a tertiary care neonatal intensive care unit (NICU) in India. A total of 1431 neonates, including term and preterm, underwent POS at two time points. Screening followed the modified American Academy of Pediatrics algorithm, with echocardiographic follow-up for positive screens. Sensitivity, specificity, positive predictive value, and negative predictive value (NPV) were calculated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Of the enrolled neonates (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 1431), dual screening identified 95 positives (6.64%): 11 CCHD, 38 noncritical CHD and 46 noncardiac hypoxemic conditions. Dual POS had higher sensitivity (73.33% vs. 60%) and NPV (99.7% vs. 99.54%), and a lower false-negative rate (26.66% vs. 40%). POS 2 detected 2 additional CCHDs missed by POS1. Among 1336 negatives, clinical follow-up found 4 CCHDs.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Dual POS significantly improves CCHD detection over single screening while identifying treatable noncardiac hypoxemic conditions. This nurse-led protocol is feasible even in resource-constrained NICUs, warranting routine adoption alongside clinical examination to minimize missed diagnoses of CCHD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/heartviews.heartviews_17_26","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T06:00:08Z","timestamp":1788501608000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Should Dual Pulse Oximetry Screening Be Used in Neonates? The Insights from the CHOOSE Study"],"prefix":"10.4103","volume":"27","author":[{"given":"Neha","family":"Singh","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Netaji Subhash Chandra Bose (NSCB) Medical College, Jabalpur, Madhya Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaya","family":"Upadhyay","sequence":"additional","affiliation":[{"name":"Neonatology (Super-specialty hospital), Netaji Subhash Chandra Bose (NSCB) Medical College, Jabalpur, Madhya Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Lazarus","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Netaji Subhash Chandra Bose (NSCB) Medical College, Jabalpur, Madhya Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shishir","family":"Soni","sequence":"additional","affiliation":[{"name":"Cardiology (Super-specialty hospital), Netaji Subhash Chandra Bose (NSCB) Medical College, Jabalpur, Madhya Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,1]]},"reference":[{"key":"R1-20260904","doi-asserted-by":"crossref","first-page":"871","DOI":"10.1186\/s12884-023-06193-1","article-title":"Evaluation of critical congenital heart disease from 2018 to 2020 in Turkey: A retrospective cohort study","volume":"23","author":"\u00c7aylan","year":"2023","journal-title":"BMC Pregnancy Childbirth"},{"key":"R2-20260904","doi-asserted-by":"crossref","first-page":"259","DOI":"10.2471\/BLT.14.140996","article-title":"Inequities in postnatal care in low- and middle-income countries: A systematic review and meta-analysis","volume":"93","author":"Langlois \u00c9","year":"2015","journal-title":"Bull World Health Organ"},{"key":"R3-20260904","doi-asserted-by":"crossref","first-page":"e028139","DOI":"10.1136\/bmjopen-2018-028139","article-title":"Prenatal diagnosis and prevalence of critical congenital heart defects: An international retrospective cohort study","volume":"9","author":"Bakker","year":"2019","journal-title":"BMJ Open"},{"key":"R4-20260904","doi-asserted-by":"crossref","first-page":"2459","DOI":"10.1016\/S0140-6736(12)60107-X","article-title":"Pulse oximetry screening for critical congenital heart defects in asymptomatic newborn babies: A systematic review and meta-analysis","volume":"379","author":"Thangaratinam","year":"2012","journal-title":"Lancet"},{"key":"R5-20260904","first-page":"CD011912","article-title":"Pulse oximetry screening for critical congenital heart defects","volume":"3","author":"Plana","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"key":"R6-20260904","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1016\/j.jpeds.2007.12.043","article-title":"First day of life pulse oximetry screening to detect congenital heart defects","volume":"152","author":"Meberg","year":"2008","journal-title":"J Pediatr"},{"key":"R7-20260904","doi-asserted-by":"crossref","first-page":"823","DOI":"10.1542\/peds.2009-1397","article-title":"Role of pulse oximetry in examining newborns for congenital heart disease: A scientific statement from the AHA and AAP","volume":"124","author":"Mahle","year":"2009","journal-title":"Pediatrics"},{"key":"R8-20260904","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1016\/j.clp.2021.05.008","article-title":"Perinatal cardiovascular physiology and recognition of critical congenital heart defects","volume":"48","author":"Singh","year":"2021","journal-title":"Clin Perinatol"},{"key":"R9-20260904","doi-asserted-by":"crossref","first-page":"e20174065","DOI":"10.1542\/peds.2017-4065","article-title":"A modified algorithm for critical congenital heart disease screening using pulse oximetry","volume":"141","author":"Diller","year":"2018","journal-title":"Pediatrics"},{"key":"R10-20260904","doi-asserted-by":"crossref","first-page":"F176","DOI":"10.1136\/adc.2006.107656","article-title":"Accuracy of pulse oximetry in screening for congenital heart disease in asymptomatic newborns: A systematic review","volume":"92","author":"Thangaratinam","year":"2007","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"key":"R11-20260904","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3310\/hta16020","article-title":"Pulse oximetry as a screening test for congenital heart defects in newborn infants: A test accuracy study with evaluation of acceptability and cost-effectiveness","volume":"16","author":"Ewer","year":"2012","journal-title":"Health Technol Assess"},{"key":"R12-20260904","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"},{"key":"R13-20260904","doi-asserted-by":"crossref","first-page":"F416","DOI":"10.1136\/archdischild-2014-307485","article-title":"Pulse oximetry as a screening tool for detecting major congenital heart defects in Indian newborns","volume":"100","author":"Saxena","year":"2015","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"key":"R14-20260904","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1007\/s00431-021-04275-w","article-title":"Impact of pulse oximetry screening to detect congenital heart defects: 5 years\u2019 experience in a UK regional neonatal unit","volume":"181","author":"Singh","year":"2022","journal-title":"Eur J Pediatr"},{"key":"R15-20260904","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1136\/archdischild-2021-322303","article-title":"Temporal trends in routine predischarge pulse oximetry screening: 6 years\u2019 experience in a UK regional neonatal unit","volume":"107","author":"Henderson","year":"2022","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"key":"R16-20260904","doi-asserted-by":"crossref","first-page":"2064","DOI":"10.1080\/14767058.2018.1538348","article-title":"Pulse oximetry screening for critical congenital heart disease: A comparative study of cohorts over 11 years","volume":"33","author":"Banait","year":"2020","journal-title":"J Matern Fetal Neonatal Med"},{"key":"R17-20260904","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1007\/s00431-005-0006-y","article-title":"The contribution of pulse oximetry to the early detection of congenital heart disease in newborns","volume":"165","author":"Arlettaz","year":"2006","journal-title":"Eur J Pediatr"},{"key":"R18-20260904","first-page":"370","article-title":"Early screening for critical congenital heart defects in asymptomatic newborns in Mazovia province: Experience of the POLKARD pulse oximetry programme 2006-2008 in Poland","volume":"70","author":"Turska Kmie\u0107","year":"2012","journal-title":"Kardiol Pol"},{"key":"R19-20260904","doi-asserted-by":"crossref","first-page":"1261","DOI":"10.1097\/CM9.0000000000002031","article-title":"Impact of clinical research on public health policy of neonatal screening for congenital heart disease in China","volume":"135","author":"Yang","year":"2022","journal-title":"Chin Med J (Engl)"},{"key":"R20-20260904","doi-asserted-by":"crossref","first-page":"F33","DOI":"10.1136\/adc.2007.119032","article-title":"Twenty-year trends in diagnosis of life-threatening neonatal cardiovascular malformations","volume":"93","author":"Wren","year":"2008","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"key":"R21-20260904","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1111\/j.1651-2227.2006.tb02253.x","article-title":"Failure to diagnose critical heart malformations in newborns before discharge \u2013 An increasing problem?","volume":"95","author":"Mellander","year":"2006","journal-title":"Acta Paediatr"},{"key":"R22-20260904","first-page":"1","article-title":"Pulse oximetry as a screening test for congenital heart disease in newborns","volume":"26","author":"Janjua","year":"2022","journal-title":"J Mother Child"},{"key":"R23-20260904","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1016\/S0140-6736(14)60198-7","article-title":"Pulse oximetry with clinical assessment to screen for congenital heart disease in neonates in China: A prospective study","volume":"384","author":"Zhao","year":"2014","journal-title":"Lancet"},{"key":"R24-20260904","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"},{"key":"R25-20260904","doi-asserted-by":"crossref","first-page":"F219","DOI":"10.1136\/adc.2005.090282","article-title":"Should pulse oximetry be used to screen for congenital heart disease?","volume":"92","author":"Valmari","year":"2007","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"key":"R26-20260904","doi-asserted-by":"crossref","first-page":"682","DOI":"10.1111\/j.1651-2227.2008.01199.x","article-title":"Pulse oximetry screening as a complementary strategy to detect critical congenital heart defects","volume":"98","author":"Meberg","year":"2009","journal-title":"Acta Paediatr"},{"key":"R27-20260904","doi-asserted-by":"crossref","first-page":"444","DOI":"10.26502\/fccm.92920468","article-title":"Pulse oximetry screening for critical congenital heart defects: Effectiveness and implementation across clinical settings","volume":"9","author":"Gurumurthy","year":"2025","journal-title":"Cardiol Cardiovasc Med"},{"key":"R28-20260904","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/j.jpeds.2013.08.044","article-title":"Quality improvement in screening for critical congenital heart disease","volume":"164","author":"Oster","year":"2014","journal-title":"J Pediatr"}],"container-title":["Heart Views"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/heartviews.heartviews_17_26","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T06:00:12Z","timestamp":1788501612000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/heartviews.heartviews_17_26"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":28,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/heartviews.heartviews_17_26","relation":{},"ISSN":["1995-705X","0976-5123"],"issn-type":[{"value":"1995-705X","type":"print"},{"value":"0976-5123","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2026-01-29","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-17","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}