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Am J Perinatol 2023; 40(15): 1611-1617
DOI: 10.1055/s-0042-1748163
Review Article

Pulse Oximetry and Perfusion Index Screening for Congenital Heart Defects: A Systematic Review and Meta-analysis

S. L. Jiang 
1   Department of Pediatrics, West China Second University Hospital, Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, Sichuan University, Chengdu, People's Republic of China
,
Y. J. Zhan
1   Department of Pediatrics, West China Second University Hospital, Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, Sichuan University, Chengdu, People's Republic of China
,
P. Yan
2   Department of Gastroenterology, West China Hospital, Sichuan University, No. 37, Guo Xue Alley, Wu Hou District, Chengdu, Sichuan, People's Republic of China
,
Y. Yue
1   Department of Pediatrics, West China Second University Hospital, Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, Sichuan University, Chengdu, People's Republic of China
,
J. Tang
1   Department of Pediatrics, West China Second University Hospital, Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, Sichuan University, Chengdu, People's Republic of China
› Author Affiliations
Funding This work was supported by the grants from the Science and Technology Bureau of Sichuan Province (grant no.: 2020YJ0236), the grants from the National Science Foundation of China (grant nos.: os. 81630038 and 81971433), the grant from Ministry of Education of China [IRT0935], and the grant of clinical discipline program (Neonatology) from the Ministry of Health of China (grant no.: 1311200003303). All the funds belong to Jun Tang.
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Abstract

Congenital heart defects (CHDs) are the most common neonatal malformations and are a leading cause of infant death in developed countries. Finding safe and effective diagnostic methods to screen for CHDs is important. The aim of this study was to evaluate the effectiveness of pulse oximetry (PO) and perfusion index (PI) in screening CHD. We conducted a systematic review of studies in PubMed, Embase, and the Cochrane Library published on or before October 1, 2021. Studies based on PICOS were included in this systematic review. The flow chart is made by PRISMA software. The quality of included studies was assessed by RevMan5 software (QUADAS-2: Quality Assessment of Diagnostic Accuracy Studies-2). The sensitivity, specificity, and other measurements of accuracy were pooled using Stata/SE 12.0 software. Five studies containing 46,965 neonates were included in this study. A randomized-effects model was used for the meta-analysis because of significant heterogeneity. The combined sensitivity and specificity were 0.82 (95% confidence interval [CI], 0.53–0.95) and 0.97 (95% CI, 0.57–1.00), respectively. The area under the curve was 0.92 (95% CI, 0.89–0.94). The combination PO and PI was significant in CHD screening. Once diagnosed by the combined method, it means that the neonate is most likely to have a CHD.

Key Points

  • Pulse oximetry and PI screening.

  • Congenital heart defects.

  • A systematic review and meta-analysis.

Keywords

congenital heart defect - screening - newborn - perfusion index

Ethical Approval

This article does not contain any studies with human participants or animals performed by any of the authors.




Publication History

Received: 26 October 2021

Accepted: 04 March 2022

Article published online:
17 May 2022

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