Key Findings: Study Finds Infant Cardiac Deaths Have Declined in States that Mandate Screening for Critical Congenital Heart Disease

The Journal of the American Medical Association has published a study reporting a more than 33% decline in infant deaths from critical congenital heart disease (CCHD) in eight states that mandated screening for CCHD using pulse oximetry (a non-invasive way to measure the level of oxygen in an infant’s blood) compared to states without screening policies. CCHD screening nationwide is projected to save at least 120 babies each year. This study is the first look at the impact of state policies to either require or recommend screening of infants for CCHD at birth. You can read the scientific summary here.

The study, Association of U.S. State Implementation of Newborn Screening Policies for Critical Congenital Heart Disease With Infant Cardiac Deaths, shows that states that mandated their hospitals to use ‘pulse oximetry’ testing as a newborn screening measure saw the most significant decrease in infant deaths compared to states without screening policies. Policies that were voluntary or not yet implemented were not associated with reductions in infant death rates. The encouraging news is that 47 states and the District of Columbia now have mandatory screening policies in place and one additional state, California, requires screening be offered.

About Congenital Heart Disease and this Study

In 2011, the U.S. Department of Health and Human Services added critical congenital heart disease to its list of conditions (Recommended Uniform Screening Panel for Newborns ) that States were encouraged to require for newborn screening.

For this study researchers used U.S. data on infant deaths between 2007 and 2013 that were classified by month and state of birth, births through June 2013 were included and followed for 6 months. Researchers compared the numbers of deaths prior to 6 months of age with congenital heart defects listed as the underlying cause of death among infants born after States had implemented screening policies with those born when no screening policy had been implemented. Researchers compared three types of screening policies: a voluntary recommendation to screen, a mandate (requirement) to screen that was adopted but not yet implemented, and a mandate to screen that had been fully implemented.

Main Findings from this Study

A 33% decline in infant deaths from CCHD and a 21% decline in infant deaths from other or unspecified cardiac causes were observed in eight states with mandated and implemented screening policies compared to states without mandated screening policies.
Adoption of other screening policies (voluntary policies or mandatory policies not yet implemented) was not associated with reductions in infant deaths.
Mandatory screening policies applied nationwide are projected to save about 120 babies each year.

More Information

To learn more about congenital heart defects, visit https://www.cdc.gov/ncbddd/heartdefects/index.html

and https://www.cdc.gov/features/congenitalheartdefects/.

References

Rahi, A., Grosse, SD, Ailes, EC, Oster, ME. Association of US State Implementation of Newborn Screening Policies for Critical Congenital Heart Disease With Early Infant Cardiac Deaths. JAMA. 2017;318(21):1-8.