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Newborn Critical Congenital Heart Disease Screening Program Requirements

By Conrad Meyer

During the 2013 legislative session, Act 407 was enrolled, implementing the Newborn Critical Congenital Heart Disease Screening Program. Effective August 1, 2013, the new law creates a program requiring all birthing facilities, defined as an inpatient or ambulatory healthcare facility licensed by the Department of Health and Hospitals that provides birthing and newborn care services, to screen all Louisiana newborns for congenital heart defects.

Such defects are described as structural abnormalities of the heart that are present at birth and range in severity from simple problems, such as holes between chambers of the heart, to severe malfunctions, such as the complete absence of one or more chambers or valves. According to the Centers for Disease Control and Prevention, congenital heart defects occur in approximately one in one hundred ten births in the United States.

Current methods of screening for congenital heart defects generally include prenatal ultrasound screenings and repeated clinical examinations; however, these methods often miss defects that can be detected by pulse oximetry screening. This law defines pulse oximetry screening as a noninvasive test that estimates the percentage of hemoglobin in blood that is saturated with oxygen to detect congenital heart defects. When screening such as pulse oximetry is performed on a newborn in a birthing facility, it is believed to be effective in detecting life-threatening defects.

These findings are further supported by the Secretary of Health and Human Services (HHS), who recommended on September 21, 2011, that screening for critical congenital heart disease be added to the recommended uniform screening panel. In addition to the HHS, the American Academy of Pediatrics has been a strong advocate of early detection of congenital heart defects through pulse oximetry.

Furthermore, according to the Centers for Disease Control and Prevention, the costs of pulse oximetry screening has been estimated to cost less than $15.00 per infant, with an average time of approximately 10 minutes per screen.

As a result of these findings, the Newborn Critical Congenital Heart Disease Screening Program requires that every birthing facility in Louisiana perform pulse oximetry screening on each newborn before discharge, unless prohibited by the parent or guardian of the newborn.