Li Mengwen, He Dan, Peng Tingting, Liu Rui, Tang Binzhi
Department of Pediatrics, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.
Department of Cardiology, Chengdu Jinniu District People's Hospital (Sichuan Provincial People's Hospital Jinniu Hospital), Chengdu, Sichuan Province, China.
Sci Rep. 2025 Jul 19;15(1):26204. doi: 10.1038/s41598-025-10450-y.
To examine the value of"joint index"in the early and rapid screening of congenital heart disease (CHD) in newborns. The study selected live-born neonates who were delivered in the Department of Obstetrics and Gynecology at Sichuan Provincial People's Hospital from January 1, 2023 to December 31, 2023. Cardiac auscultation and pulse oximetry were performed at 6 h to 72 h after birth. To further elucidate the diagnosis and to analyze and compare the value of cardiac murmur, pulse oximetry, and the combination of cardiac murmur and pulse oximetry for the early diagnosis of CHD, cardiac ultrasonography was performed on newborns with positive screening for either cardiac murmur or pulse oximetry. The value of heart murmur, pulse oximetry, and their combination was assessed in the early diagnosis of CHD. A total of 3037 newborns were screened following the inclusion and exclusion criteria. Of them, a total of 304 positive cases were included in the present study and were divided into 3 groups: 142 cases in the heart murmur group, 99 cases in the oxygen saturation group, and 304 cases in the combined group of those who were positive for both heart murmur and/or oxygen saturation. A total of 215 cases of CHD were diagnosed via cardiac ultrasound in screen-positive newborns, including 26 cases of severe CHD. The top three types of CHD were atrial septal defect (33.95%), ventricular septal defect (26.05%), and arterial duct failure (20.47%). The diagnostic sensitivity, accuracy, and negative predictive value of the combined group were 100%, 97.07%, and 100%, respectively. These values were significantly higher than those of the heart murmur group and the oxygen saturation group (P < 0.01), and the overall difference among the three groups in terms of the positive predictive value was not statistically significant (P > 0.05). However, in the two-by-two comparisons within the groups, the positive predictive value of the combined group was greater than that of the oxygen saturation group, and the difference was statistically significant (70.72% vs. 50.89%; P < 0.05). The specificity of the combined group was 96.85%, which was lower than that of the murmur and oxygenation groups (98.37% vs. 98.55%; P < 0.01). However, considering the detection of severe CHD, a total of 14 cases of severe CHD were detected in patients with positive cardiac murmur and oxygenation in the combined group (53.83%), which was significantly higher than that in the murmur group (11.54%) and oxygenation group (34.62%, P < 0.01). The newborns can be screened for CHD using heart murmur auscultation combined with pulse oximetry, which is a convenient, sensitive, and accurate method. It can be utilized as an important tool for early clinical screening for CHD.
探讨“联合指标”在新生儿先天性心脏病（CHD）早期快速筛查中的价值。本研究选取2023年1月1日至2023年12月31日在四川省人民医院妇产科分娩的活产新生儿。出生后6小时至72小时进行心脏听诊和脉搏血氧饱和度测定。为进一步明确诊断并分析比较心脏杂音、脉搏血氧饱和度以及心脏杂音与脉搏血氧饱和度联合检测对CHD早期诊断的价值，对心脏杂音或脉搏血氧饱和度筛查阳性的新生儿进行心脏超声检查。评估心脏杂音、脉搏血氧饱和度及其联合检测在CHD早期诊断中的价值。按照纳入和排除标准共筛查3037例新生儿。其中，本研究共纳入304例阳性病例，分为3组：心脏杂音组142例，血氧饱和度组99例，心脏杂音和/或血氧饱和度均为阳性的联合组304例。经心脏超声诊断筛查阳性新生儿中共有215例CHD，其中重度CHD 26例。CHD前三位类型为房间隔缺损（33.95%）、室间隔缺损（26.05%）和动脉导管未闭（20.47%）。联合组的诊断敏感性、准确性和阴性预测值分别为100%、97.07%和100%。这些值显著高于心脏杂音组和血氧饱和度组（P＜0.01），三组在阳性预测值方面的总体差异无统计学意义（P＞0.05）。然而，在组内两两比较中，联合组的阳性预测值大于血氧饱和度组，差异有统计学意义（70.72%对50.89%；P＜0.05）。联合组的特异性为96.85%，低于杂音组和氧合组（98.37%对98.55%；P＜0.01）。然而，考虑到重度CHD的检测，联合组中心脏杂音和氧合阳性患者共检测出14例重度CHD（53.83%），显著高于杂音组（11.54%）和氧合组（34.62%，P＜0.01）。可采用心脏杂音听诊联合脉搏血氧饱和度测定对新生儿进行CHD筛查，这是一种方便、灵敏且准确的方法。它可作为CHD早期临床筛查的重要工具。
