FEBRUARY 3, 2015 – DC AAP Fetus & Newborn Committee Chairperson, Dr. Mary Revenis, and Executive Director, Nancy Schoenfeld, testified on behalf of DC AAP in support of Bill 21-6, the “Healthy Hearts of Babies Act of 2015” at the DC Council’s Health and Human Services Committee Hearing. Also testifying were DC AAP members, Dr. Gerard Martin, Senior Vice President & Medical Director of Children’s National Health System, and Dr. Joseph Wright, Chair of Howard University Department of Pediatrics, as well as a number of parents and children whose lives have been touched by Critical Congenital Heart Disease. The bill mandates that the Department of Health require hospitals and maternity centers to perform congenital heart defect screening on every newborn at its facility prior to discharge.
Dr. Martin, Dr. Wright and Nancy Schoenfeld’s testimony begin at 00:26:40 and Dr. Revenis’s testimony begins at 02:01:45.
Critical congenital heart disease or “CCHD” affects approximately 7,200 newborns every year in the United States and is one of the leading causes of infant deaths. If not detected early, CCHD can have profound consequences on a child’s life. However, pulse oximetry screening, which is readily available, noninvasive, and painless, can help detect CCHD in newborns. Pulse oximetry screening is inexpensive, with a recent study putting the cost of screening a newborn between $6 and $7 and the incremental cost of screening at less than a dollar per newborn using reusable sensors.
In September 2011, the Secretary of the US Department of Health and Human Services (HHS) formally adopted the recommendation from the Secretary’s Advisory Committee on Heritable Disorders in Newborns and Children to add CCHD to the Recommended Uniform Screening Panel (RUSP).[i] Following this recommendation, members of the Advisory Committee, the American Academy of Pediatrics (AAP), the American College of Cardiology (ACC), and the American Hospital Association (AHA) issued “Strategies for Implementing Screening for Critical Congenital Heart Disease,” which addressed critical issues such as necessary equipment, personnel, and training, and provided specific recommendations for assessment of saturation by using pulse oximetry as well as appropriate management of a positive screening result.
In addition, the AAP issued a policy statement endorsing the decision of the Secretary of HHS to add critical congenital heart disease to the RUSP.
The AAP recommends:
- Screening should be conducted by using motion-tolerant pulse oximeters that report functional oxygen saturation and have been cleared by the FDA for use in newborns.
- Screening should not be undertaken until 24 hours of life or as late as possible if early discharge from the hospital or birthing center is planned in order to reduce the number of false-positive results. Considerations are necessary to ensure newborns born in home births are screened.
- Screening should be based on a recommended algorithm.
- Screening should be performed by qualified personnel who have been educated in the use of the algorithm and trained in pulse oximetry monitoring of newborns.
- Hospitals and birthing centers should establish partnerships with local and state public health agencies to develop strategies for quality assurance and monitor the impact of screening
- Primary care physicians should ensure that newborns in their practice were appropriately screened following birth and should work to facilitate long-term follow-up for children diagnosed with CCHD.