MMWR Morb Mortal Wkly Rep. 2019 Feb 8;68(5):107-111. doi: 10.15585/mmwr.mm6805a3.
In 2011, the U.S. Department of Health and Human Services added critical congenital heart disease (CCHD), which occurs in two of every 1,000 births, to the list of conditions recommended to states for universal newborn screening (1). Without early detection, infants with CCHD are at risk for substantial morbidity and death in the first weeks and months of life (2). Based on 2007-2013 data, deaths from CCHD and other cardiac causes in infants aged <6 months significantly declined in infants born in eight states after they had fully implemented mandated newborn CCHD screening policies by June 2013 (3). CDC collaborated with the American Academy of Pediatrics (AAP) and the Association of Public Health Laboratories' Newborn Screening Technical Assistance and Evaluation Program (NewSTEPs) to update a 2015 report (4) on states' actions toward adopting and implementing policies supporting CCHD newborn screening. In 2018, all 50 states and the District of Columbia (DC) had implemented CCHD screening policies, and, with one exception, all states mandated that screening be done (California mandates that screening be offered). However, not all states had data systems in place for tracking all screening results and outcomes. Ongoing evaluation activities, which rely on screening data, could help identify program improvement opportunities and monitor the impact of early identification of CCHD.
2011 年,美国卫生与公众服务部将先天性心脏病(CCHD)添加到建议各州进行普遍新生儿筛查的条件列表中,CCHD 的发病率为每千例活产儿中有 2 例(1)。如果不能早期发现,患有 CCHD 的婴儿在生命的最初几周和几个月内有发生严重发病率和死亡的风险(2)。根据 2007-2013 年的数据,在 2013 年 6 月之前,八个州完全实施了强制性新生儿 CCHD 筛查政策后,在这些州出生的 <6 个月龄婴儿中,CCHD 和其他心脏原因导致的死亡人数显著下降(3)。CDC 与美国儿科学会(AAP)和公共卫生实验室协会的新生儿筛查技术援助和评估计划(NewSTEPs)合作,更新了 2015 年关于各州采取行动通过和实施支持 CCHD 新生儿筛查政策的报告(4)。2018 年,所有 50 个州和哥伦比亚特区(DC)都实施了 CCHD 筛查政策,除了一个例外,所有州都要求进行筛查(加利福尼亚州要求提供筛查)。然而,并非所有州都建立了跟踪所有筛查结果和结局的系统。正在进行的评估活动依赖于筛查数据,可以帮助确定计划改进的机会,并监测早期发现 CCHD 的影响。