Cardiac Death at Birth; Screening for Congenital Heart Disease

On December 5, 2017, the CDC announced a report finding that infant deaths from critical congenital heart disease (CCHD) decreased more than 33 percent in eight states that mandated screening for CCHD. In addition, deaths from other or unspecified cardiac causes decreased by 21 percent in the states that mandated CCHD screening.


Screening for CCHD uses a test called pulse oximetry. Pulse oximetry is a simple bedside test to determine the amount of oxygen in a baby’s blood and the baby’s pulse rate. Low levels of oxygen in the blood can be a sign of a CCHD.


CCHD screening nationwide could save at least 120 babies each year, according to the study. This study was the first look at the impact of state policies to either require or recommend screening of infants for CCHD at birth.


The study showed that states that required their hospitals to screen newborns with pulse oximetry saw the most significant decrease in infant deaths compared with states without screening policies. Voluntary policies or mandated policies not yet implemented were not associated with reductions in infant death rates. The encouraging news is that 47 states and D.C. now have mandatory screening policies in place and one additional state, California, requires screening be offered. These results serve as a reminder to hospitals across the country to remain vigilant in their screening for CCHD.


“More families are able to celebrate special milestones in a child’s life thanks to the early identification and treatment of heart defects,” said CDC Director Brenda Fitzgerald, M.D. “Screening newborns for critical congenital heart disease in every state, tribe, and territory will save lives and help babies thrive.”


Approximately one in every four babies born with a congenital heart defect has CCHD and will need surgery or other procedures in the first year of life. In the U.S., approximately 7,200 babies born each year have one of seven critical CCHDs. The seven defects classified as critical congenital heart defects (CCHDs) are hypoplastic left heart syndrome, pulmonary atresia (with intact septum), tetralogy of Fallot, total anomalous pulmonary venous return, transposition of the great arteries, tricuspid atresia, and truncus arteriosus. Babies with one these CCHDs are at significant risk for death or disability if the heart defect is not diagnosed and treated soon after birth.  Without screening by a pulse oximetry reading, some babies born with a congenital heart defect can appear healthy at first and be sent home with their families before the heart defect is detected. Other heart defects can be just as severe as these seven CCHDs and also require treatment soon after birth. However, pulse oximetry screening may not detect these heart defects as consistently as the seven disorders listed as CCHDs.


See the CDC Announcement


See also Medical Law Perspectives Report: Congenital Heart Conditions: How Infants, Adults, and Healthcare Providers Handle the Risks


See also Medical Law Perspectives Report: Pediatrician Liability Involving Diseases and Conditions of Childhood


See also Medical Law Perspectives Report: Mothers, Infants, and Obstetrical Injuries: Labor and Delivery Liability Risks