Congenital Heart Disease Clinical Trial
Official title:
Accuracy Assessment of 7 Clinical Indicators in Newborn Screening for Congenital Heart Disease
The purpose of this study is to test the accuracy of 7 indicators in screening congenital heart defects (CHD) in all newborns (symptomatic or asymptomatic) to determine whether these indicators could be applied in the nationwide newborn CHD screening. The investigator's hypothesis is that 7 indicators are effective in neonate CHD screening with the acceptable accuracy.
Congenital heart defects (CHD) are among the most common major congenital anomalies, and
they occur worldwide with an incidence of about 8-12/1,000 live births , Most of these
defects are mild or moderate. They either do not need treatment or treatment is needed only
after infancy. Other defects are severe and require early treatment in infancy, which are
the primary objectives of screening, because they are at risk of adverse or irreversible
outcomes as a consequence of congenital heart defects. However, about half the neonates in
the nursery have no distinctive clinical signs (symptoms, abnormal murmurs or cyanosis).So
it's necessary to develop a screening strategy for neonatologist and pediatrician,
especially physicians in community. Screening strategy in our study consists of 7
indicators: Family history of CHD, tachypnea, heart murmurs(≥ 2 grade), cyanosis, other
non-cardiac malformations,special face feature(relating to chromosomal or non-chromosomal
syndromes), subnormal Pulse Oximetry reading (Oxygen saturation of less than 95% in either
limb or more than 3% difference)。The newborn babies with any of these 7 indicators positive
will be considered positive-screened and echocardiography will performed.
The whole study (screening for CHDs with 7 indicators and performing the echocardiography
for diagnosis) will be conducted by one single investigator (Quming Zhao from Children's
Hospital of Fudan University). The new generation Pulse Oximetry has been proved to have low
intraobserver and interobserver variability, but the interobserver variability in clinical
evaluation (especially murmurs and cyanosis) remain unknown, the investigator will also
assess the interobserver variability by comparing Quming Zhao and other two pediatricians
(from the participating Hospital)(blind to each other).
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Observational Model: Cohort, Time Perspective: Prospective
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