A new algorithm DEtectS critical Congenital Heart Disease at different altitudes: ANDES-CHD study

Katia Bravo-Jaimes, Tania Vasquez-Loarte, Jose Rojas-Camayo, Monica Medina, Christian R. Mejia, Henry Zapata-Galarza, Marilia Berrocal, Jeanette Orozco, Daniel Lozano, Maryuri Santivañez, Carlos Sangay, William Rosales, Leddy Mamani, Nelly Macedo, Joel Coronado, Gian Huaman, Rafael Marquez, Zhuo Li, Kiran M. Masood, Juan AlejosLeigh Reardon, Jeannette Lin

Research output: Contribution to journalOriginal Articlepeer-review

Abstract

Background: Neonatal pulse oximetry screening (POS) algorithms for critical congenital heart disease (CCHD) have contributed towards decreasing neonatal mortality but cannot be applied at high altitudes. New POS algorithms at high altitudes are needed. Methods: This observational, prospective study included newborns born at different altitudes from 0 to 4380 meters above the sea level in Peru. Healthy newborns underwent neonatal preductal and postductal oximetry, echocardiography and telephonic follow-up up to 12 months of age. Newborns with CCHD underwent preductal and postductal oximetry at the time of telemedicine evaluation while located at the high-altitude hospital where they were born, and their diagnoses were confirmed with echocardiography locally or after arriving to the referral center. Two new algorithms were designed using clinically accepted neonatal oximetry cutoffs or the 5th and 10th percentiles for preductal and postductal oximetry values. Results: A total of 502 healthy newborns and 15 newborns with CCHD were enrolled. Echocardiography and telephonic follow-up were completed in 227 (45%) and 330 healthy newborns (65%), respectively. The algorithm based on clinically accepted cutoffs had a sensitivity of 92%, specificity of 73% and false positive rate of 27% The algorithm based on the 5th and 10th percentiles had a sensitivity of 80%, specificity of 88% and false positive rate of 12%. Conclusions: Two algorithms that detect CCHD at different altitudes had adequate performance but high false positive rates.

Original languageAmerican English
Pages (from-to)373-378
Number of pages6
JournalJournal of Perinatology
Volume44
Issue number3
DOIs
StateIndexed - Mar 2024
Externally publishedYes

Bibliographical note

Publisher Copyright:
© The Author(s), under exclusive licence to Springer Nature America, Inc. 2024.

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