Women's Health Research Unit, Centre for Primary Care and Public Health, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
Birmingham Women's NHS Foundation Trust, Birmingham, UK.
Lancet. 2012 Jun 30;379(9835):2459-2464. doi: 10.1016/S0140-6736(12)60107-X. Epub 2012 May 2.
Screening for critical congenital heart defects in newborn babies can aid in early recognition, with the prospect of improved outcome. We assessed the performance of pulse oximetry as a screening method for the detection of critical congenital heart defects in asymptomatic newborn babies.
In this systematic review, we searched Medline (1951-2011), Embase (1974-2011), Cochrane Library (2011), and Scisearch (1974-2011) for relevant citations with no language restriction. We selected studies that assessed the accuracy of pulse oximetry for the detection of critical congenital heart defects in asymptomatic newborn babies. Two reviewers selected studies that met the predefined criteria for population, tests, and outcomes. We calculated sensitivity, specificity, and corresponding 95% CIs for individual studies. A hierarchical receiver operating characteristic curve was fitted to generate summary estimates of sensitivity and specificity with a random effects model.
We screened 552 studies and identified 13 eligible studies with data for 229,421 newborn babies. The overall sensitivity of pulse oximetry for detection of critical congenital heart defects was 76·5% (95% CI 67·7-83·5). The specificity was 99·9% (99·7-99·9), with a false-positive rate of 0·14% (0·06-0·33). The false-positive rate for detection of critical congenital heart defects was particularly low when newborn pulse oximetry was done after 24 h from birth than when it was done before 24 h (0·05% [0·02-0·12] vs 0·50 [0·29-0·86]; p=0·0017).
Pulse oximetry is highly specific for detection of critical congenital heart defects with moderate sensitivity, that meets criteria for universal screening.
None.
对新生儿进行先天性心脏病筛查可以帮助早期发现，从而提高治疗效果。我们评估了脉搏血氧饱和度筛查无症状新生儿先天性心脏病的表现。
本系统评价检索了 Medline（1951-2011）、Embase（1974-2011）、Cochrane 图书馆（2011）和 Scisearch（1974-2011），无语言限制。我们选择了评估脉搏血氧饱和度检测无症状新生儿先天性心脏病的准确性的研究。两位评审员选择了符合人群、检测和结局预定义标准的研究。我们为每项研究计算了敏感性、特异性和相应的 95%CI。使用随机效应模型拟合分层受试者工作特征曲线，生成敏感性和特异性的汇总估计值。
我们筛选了 552 篇研究，确定了 13 项符合条件的研究，这些研究共有 229421 名新生儿的数据。脉搏血氧饱和度检测先天性心脏病的总体敏感性为 76.5%（95%CI 67.7-83.5）。特异性为 99.9%（99.7-99.9），假阳性率为 0.14%（0.06-0.33）。与出生后 24 小时内进行相比，出生后 24 小时后进行新生儿脉搏血氧饱和度检测时，先天性心脏病的假阳性率特别低（0.05%[0.02-0.12] vs 0.50%[0.29-0.86]；p=0.0017）。
脉搏血氧饱和度对先天性心脏病的检测特异性高，敏感性适中，符合普遍筛查的标准。
无。
