Department of Medicine Solna, Clinical Epidemiology Unit, Karolinska Institutet, Stockholm, Sweden.
Division of Obstetrics and Gynecology, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
Arch Dis Child Fetal Neonatal Ed. 2020 Jul;105(4):375-379. doi: 10.1136/archdischild-2019-317066. Epub 2019 Oct 9.
To calculate diagnostic values of the femoral pulse palpation to detect coarctation of the aorta or other left-sided obstructive heart anomalies in newborn infants.
Population-based cohort study.
Stockholm-Gotland County 2008-2012.
All singleton live-born infants without chromosomal trisomies, at ≥35 gestational weeks, followed-up until 1-2 years of age.
Diagnostic values and ORs for the femoral pulse test and subsequent diagnosis of coarctation of the aorta or left-sided obstructive heart malformation.
Among the 118 592 included infants, 432 had weak or absent femoral pulses at the newborn examination. Seventy-eight infants were diagnosed with coarcation of the aorta and 48 with other left-sided obstructive heart malformations. The diagnostic values for the femoral pulse palpation test to detect coarctation of the aorta were: sensitivity: 19.2%, specificity: 99.6, positive predictive value: 3.5% and negative predictive value: 99.9%. For left-sided heart malformations: sensitivity: 8.3%, specificity: 99.6%, positive predictive value: 0.9% and negative predictive value: 100%. Sensitivity for coarctation of the aorta increased from 16.7% when examined at <12 hours of age to 30.0% at ≥96 hours of age.
The femoral pulse test to detect coarctation of the aorta and left-sided heart malformations has limited sensitivity, whereas specificity is high. As many infants with life-threatening cardiac malformations leave the maternity ward undiagnosed, further efforts are necessary to improve the diagnostic yield of the routine newborn examination.
计算股动脉触诊检测主动脉缩窄或其他左侧阻塞性心脏异常的诊断价值，用于新生儿。
基于人群的队列研究。
2008-2012 年斯德哥尔摩-哥德堡郡。
所有无染色体三体、妊娠 35 周以上、随访至 1-2 岁的单胎活产婴儿。
股动脉试验的诊断价值和比值比（OR），以及随后主动脉缩窄或左侧阻塞性心脏畸形的诊断。
在纳入的 118592 名婴儿中，432 名新生儿检查时股动脉搏动微弱或消失。78 名婴儿被诊断为主动脉缩窄，48 名婴儿被诊断为其他左侧阻塞性心脏畸形。股动脉触诊试验检测主动脉缩窄的诊断价值为：敏感性 19.2%，特异性 99.6%，阳性预测值 3.5%，阴性预测值 99.9%。对于左侧心脏畸形：敏感性 8.3%，特异性 99.6%，阳性预测值 0.9%，阴性预测值 100%。主动脉缩窄的敏感性从出生后<12 小时的 16.7%增加到≥96 小时的 30.0%。
股动脉试验检测主动脉缩窄和左侧心脏畸形的敏感性有限，但特异性较高。由于许多患有危及生命的心脏畸形的婴儿在离开产科病房时未被诊断，因此需要进一步努力提高常规新生儿检查的诊断效果。
