Development of a Newborn Screening Program for Critical Congenital Heart Disease (CCHD) in Taipei

PLoS One. 2016 Apr 13;11(4):e0153407. doi: 10.1371/journal.pone.0153407. eCollection 2016.


Background: Early detection of critical congenital heart disease (CCHD) can significantly reduce morbidity and mortality among newborns. We investigate the feasibility of implementing a community-based newborn CCHD screening program in Taipei.

Methods: Twelve birthing facilities in Taipei participated in a trial screening program between October 1, 2013, and March 31, 2014. Newborns underwent pulse oximetry at 24-36 h old, with probes attached to the right hand and one lower limb. Any screening saturation ≥95% in either extremity, with an absolute difference of ≤3% between the right hand and foot, was accepted as a screening pass. A screening result was considered as a fail if the oxygen saturation was <95% at either probe site, on 3 separate occasions, each separated by 30 min or the first result was <95% at either probe site, and any subsequent oxygen saturation measurement was <90%. Public health nurses would follow up all missed or refused cases.

Results: Of the 6,387 live births, 6,296 newborns (coverage rate: 6,296/6,387 = 98.6%) underwent appropriate pulse oximetry screening. Sixteen newborns (0.25%) were reported to have a failed screening result. Five of these screen positive newborns were confirmed with CCHD; two of them were diagnosed solely attributed to the failed screening results. The false-positive rate was 0.18%. Implementing a 6-month screening program for CCHD produced good case detection rate, while using efficient screening and referral systems.

Conclusion: This program was successful in integrating screening, referral and public health tracking systems. The protocol outlined in this report could provide a community-based model for worldwide implementation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Early Diagnosis
  • Heart Defects, Congenital / diagnosis*
  • Humans
  • Infant, Newborn
  • Neonatal Screening / methods*
  • Oximetry / methods
  • Severity of Illness Index
  • Taiwan

Grant support

This project was partially funded by the United Way of Taiwan.