Naser Aldain A. Abu Lehyah, Abeer A. Hasan, Mahmoud Y. Abbad, Razan A. Al-Jammal, Moath K. Al Tarawneh, Dima Abu Nasrieh, Haneen A. Banihani, Saif N. Aburumman, Areen G. Fraijat, Heba M. Alhawamdeh, Qasem A. Shersheer, Milad Kh. Al-Awawdeh, Scott O. Guthrie, Joseph R. Starnes
Women’s and Children’s Hospital of Al Bashir Hospitals. King Abdullah University Hospital and University of Jordan. Al Tafilah Governmental Hospital. Vanderbilt University Medical Center.
Jordan and United States
Pediatric Reports
Pediatr Rep 2025; 17:
DOI: 10.3390/pediatric17010023
Abstract
Background/objectives: Critical congenital heart disease (CCHD) is among the major causes of global neonatal morbidity and mortality. While the incidence of CCHD appears to vary across populations, much of this variation may stem from differences in detection and reporting capabilities rather than true prevalence. In Jordan, recent data revealed a congenital cardiac disease incidence of 17.8/1000 live births, much higher than international averages. Diagnosis is largely dependent upon echocardiography, which is difficult to obtain in low-resource settings where prenatal screening modalities are limited. Screening for CCHD with pulse oximetry offers a potential method to identify patients earlier and contribute to improved outcomes.
Methods: This prospective cohort study evaluated 20,482 neonates screened using pulse oximetry at Al-Bashir Hospital between January 2022 and May 2024. Demographic data, pulse oximetry measurements, and echocardiogram findings were collected during the screening process after obtaining ethical approval from the Jordanian Ministry of Health.
Results: Pulse oximetry screening identified 752 neonates (3.7%) requiring further evaluation by echocardiography. An abnormality was detected in 240 neonates (31.9%), which included cardiac anomalies and pulmonary hypertension. Screening led to the identification of 138 infants with CCHD, including 80 with a previously unknown diagnosis, and an additional 247 infants with conditions requiring increased monitoring or treatment. Among those with CCHD, hypoplastic left heart syndrome and Tetralogy of Fallot were the most common conditions, 3.1%, and 2.4%, respectively. The overall false positive rate was 1.8% and was higher among those screened at less than 24 h of life compared to those screened at or after 24 h of life (2.3% [95%CI 2.1-2.6] vs. 0.8% [95%CI 0.6-1.0], p < 0.001).
Conclusions: Pulse oximetry screening successfully led to the early detection of CCHD among Jordanian neonates. There was a high prevalence of CCHD compared to other reported cohorts. This highlights the importance of implementing national screening protocols to improve early diagnosis and intervention. Future studies will inform the feasibility and cost-effectiveness of national implementation in this setting.
Category
Class I. Persistent Pulmonary Hypertension of the Newborn
Diagnostic Testing for Pulmonary Vascular Disease. Non-invasive Testing
Age Focus: Pediatric Pulmonary Vascular Disease
Fresh or Filed Publication: Fresh (PHresh). Less than 1-2 years since publication
Article Access
Free PDF File or Full Text Article Available Through PubMed or DOI: Yes