What screening is recommended for newborns to identify critical congenital heart disease?

Pulse oximetry screening is the recommended method for identifying critical congenital heart disease (CCHD) in newborns. This non-invasive test measures the oxygen saturation levels in a baby's blood and helps to identify those who may have a significant cardiac defect that could lead to cyanosis or low blood oxygen levels.

The rationale behind using pulse oximetry is that many congenital heart defects can lead to insufficient blood flow to the lungs, resulting in lower oxygen saturation levels. Newborn screening using pulse oximetry is typically performed before the baby is discharged from the hospital, particularly if they appear healthy at birth. If the screening suggests low oxygen saturation, further diagnostic testing can be conducted to evaluate for potential cardiac abnormalities.

Other screening methods like chest X-rays, electrocardiograms, and cardiac MRI are used in specific contexts but are not primary methods for initial screening of critical congenital heart disease. Chest X-rays can help visualize heart size and pulmonary blood flow but are not sensitive enough for early detection of many defects. Electrocardiograms assess electrical activity but do not provide information on structural defects. Cardiac MRIs are more advanced imaging techniques reserved for detailed evaluations and are not practical as an initial screening tool for newborns. Therefore, pulse oximetry is the