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先天性心脏病的新生儿筛查:上海的一项五年研究。

Newborn Screening for Congenital Heart Disease: A Five-Year Study in Shanghai.

作者信息

Tian Youping, Gu Qing, Hu Xiaojing, Ge Xiaoling, Ma Xiaojing, Yang Miao, Jia Pin, Zhang Jing, Yang Lulu, Zhao Quming, Liu Fang, Ye Ming, Yang Yulin, Huang Guoying

机构信息

National Management Office of Neonatal Screening Project for Congenital Heart Disease, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai 201102, China.

Pediatric Heart Center, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai 201102, China.

出版信息

Int J Neonatal Screen. 2025 May 17;11(2):38. doi: 10.3390/ijns11020038.


DOI:10.3390/ijns11020038
PMID:40407521
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12101202/
Abstract

This study aimed to report the progress and results of the newborn screening program for congenital heart disease (CHD) in south Shanghai between 2019 and 2023, and to evaluate the accuracy of the dual-index method (pulse oximetry (POX) plus cardiac murmur auscultation) in clinical practice. Between 2019 and 2023, a total of 198,606 (99.89%) newborns were screened for CHD, of whom 3299 (1.66%) tested positive, 3043 (92.24%) underwent echocardiography for CHD diagnosis and 1109 were diagnosed with CHD in a timely manner. Among 195,307 infants with negative screening results using the dual-index method, 139 (0.07%) were later diagnosed with CHD, and none of these infants died. More than half of these false-negative infants (59.39%) were identified due to the detection of a heart murmur during routine physical examinations within six months after birth. Compared to POX testing alone, the dual-index method significantly improved the sensitivity of screening for CHD, and kept high specificity in clinical practice. This study demonstrated that newborn screening for CHD has been well conducted in Shanghai, and the dual-index method had high accuracy and reliability for neonatal CHD screening in clinical practice.

摘要

本研究旨在报告2019年至2023年上海南部先天性心脏病(CHD)新生儿筛查项目的进展和结果,并评估双指标法(脉搏血氧饱和度(POX)加心脏杂音听诊)在临床实践中的准确性。2019年至2023年期间,共有198,606名(99.89%)新生儿接受了CHD筛查,其中3299名(1.66%)检测呈阳性,3043名(92.24%)接受了CHD诊断的超声心动图检查,1109名被及时诊断为CHD。在195,307名使用双指标法筛查结果为阴性的婴儿中,有139名(0.07%)后来被诊断为CHD,且这些婴儿均无死亡。这些假阴性婴儿中超过一半(59.39%)是由于在出生后六个月内的常规体检中检测到心脏杂音而被发现的。与单独进行POX检测相比,双指标法显著提高了CHD筛查的敏感性,并在临床实践中保持了较高的特异性。本研究表明,上海的CHD新生儿筛查工作开展良好,双指标法在临床实践中对新生儿CHD筛查具有较高的准确性和可靠性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c6dc/12101202/90cd45b6ef5a/IJNS-11-00038-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c6dc/12101202/cd50de29c27d/IJNS-11-00038-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c6dc/12101202/90cd45b6ef5a/IJNS-11-00038-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c6dc/12101202/cd50de29c27d/IJNS-11-00038-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c6dc/12101202/90cd45b6ef5a/IJNS-11-00038-g002.jpg

相似文献

[1]
Newborn Screening for Congenital Heart Disease: A Five-Year Study in Shanghai.

Int J Neonatal Screen. 2025-5-17

[2]
Impact of Newborn Screening Programme for Congenital Heart Disease in Shanghai: a five-year observational study in 801,831 newborns.

Lancet Reg Health West Pac. 2023-1-27

[3]
Pulse Oximetry and Auscultation for Congenital Heart Disease Detection.

Pediatrics. 2017-10

[4]
Large scale application of pulse oximeter and auscultation in screening of neonatal congenital heart disease.

BMC Pediatr. 2022-8-12

[5]
Pulse oximetry could significantly enhance the early detection of critical congenital heart disease in neonatal intensive care units.

Acta Paediatr. 2016-11

[6]
Accuracy of cardiac auscultation in detection of neonatal congenital heart disease by general paediatricians.

Cardiol Young. 2019-5

[7]
The Training and Evaluation of the "Dual-Index" Screening Method for Neonatal Congenital Heart Disease: A Multi-Center Study in China.

Int J Neonatal Screen. 2025-1-14

[8]
Diagnostic value of pulse oximetry combined with cardiac auscultation in screening congenital heart disease in neonates.

J Int Med Res. 2021-5

[9]
A Study on Clinical Screening of Neonatal Congenital Heart Disease in Jinjiang City.

Int J Gen Med. 2021-6-17

[10]
Pulse oximetry as a screening test for congenital heart defects in newborn infants: a test accuracy study with evaluation of acceptability and cost-effectiveness.

Health Technol Assess. 2012

本文引用的文献

[1]
Temporal trend in mortality due to congenital heart disease in China from 2008 to 2021.

Chin Med J (Engl). 2025-3-20

[2]
Safety and efficacy of COVID-19 vaccine immunization during pregnancy in 1024 pregnant women infected with the SARS-CoV-2 Omicron virus in Shanghai, China.

Front Immunol. 2023

[3]
Analysis of genetic testing in fetuses with congenital heart disease of single atria and/or single ventricle in a Chinese prenatal cohort.

BMC Pediatr. 2023-11-18

[4]
Pregnancy Termination and Postnatal Major Congenital Heart Defect Prevalence After Introduction of Prenatal Cardiac Screening.

JAMA Netw Open. 2023-9-5

[5]
Impact of Newborn Screening Programme for Congenital Heart Disease in Shanghai: a five-year observational study in 801,831 newborns.

Lancet Reg Health West Pac. 2023-1-27

[6]
Delivery and neonatal outcomes of pregnant women during the Shanghai lockdown: A retrospective analysis.

Front Pediatr. 2023-2-2

[7]
Impact of pulse oximetry screening to detect congenital heart defects: 5 years' experience in a UK regional neonatal unit.

Eur J Pediatr. 2022-2

[8]
New born pulse oximetry screening: A global perspective.

Early Hum Dev. 2021-11

[9]
COVID-19 and healthcare system in China: challenges and progression for a sustainable future.

Global Health. 2021-1-21

[10]
Epidemiology, prenatal diagnosis, and neonatal outcomes of congenital heart defects in eastern China: a hospital-based multicenter study.

BMC Pediatr. 2020-9-2

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