Oster Matthew E, Pinto Nelangi M, Pramanik Arun K, Markowsky Allison, Schwartz Bryanna N, Kemper Alex R, Hom Lisa A, Martin Gerard R
Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia.
Primary Children's Hospital, University of Utah School of Medicine, Salt Lake City, Utah.
Pediatrics. 2025 Jan 1;155(1). doi: 10.1542/peds.2024-069667.
Critical congenital heart disease (CCHD) screening was added to the US Recommended Uniform Screening Panel in 2011 and adopted by all US states and territories by 2018. In addition to reviewing key developments in CCHD screening since the initial American Academy of Pediatrics (AAP) endorsement in 2011, this clinical report provides 3 updated recommendations. First, a new AAP algorithm has been endorsed for use in CCHD screening. Compared with the original AAP algorithm from 2011, this new algorithm a) has a passing oxygen saturation threshold of ≥95% in both pre- and post-ductal measurements; and b) has only 1 retest instead of 2 for infants who did not pass the first screen. Second, to continue to improve screening, state newborn screening programs should collect a recommended minimum uniform dataset to aid in surveillance and monitoring of the program. Finally, stakeholders should be educated on the limitations of screening, the significance of non-CCHD conditions, and the importance of protocol adherence. Future directions of CCHD screening include improving overall sensitivity and implementing methods to reduce health inequities. It will remain critical that the AAP and its chapters and members work with health departments and hospitals to achieve awareness and implementation of these recommendations.
2011年，重症先天性心脏病（CCHD）筛查被纳入美国推荐统一筛查项目，并于2018年被美国所有州和领地采用。除了回顾自2011年美国儿科学会（AAP）首次认可以来CCHD筛查的关键进展外，本临床报告还提供了3项更新建议。首先，一种新的AAP算法已被认可用于CCHD筛查。与2011年的原始AAP算法相比，这种新算法：a）在导管前和导管后测量中，通过的氧饱和度阈值均为≥95%；b）对于首次筛查未通过的婴儿，只需进行1次重新检测，而不是2次。其次，为了继续改进筛查，各州新生儿筛查项目应收集建议的最低统一数据集，以协助对该项目进行监测和监督。最后，应让利益相关者了解筛查的局限性、非CCHD病症的重要性以及遵守方案的重要性。CCHD筛查的未来方向包括提高总体敏感性和实施减少健康不平等的方法。AAP及其分会和成员与卫生部门和医院合作，以实现对这些建议的认识和实施，这一点仍将至关重要。
