即將在荷蘭海牙舉辦的第九屆新生兒篩檢國際學術研討會 (The 9th ISNS International Meeting 2016) 中發表
NEWBORN SCREENING FOR CRITICAL CONGENITAL HEART DISEASES IN A REMOTE COUNTY OF SHANGHAI, CHINA
Szu-Hui Chiang (1), Yu-Shih Shiau (1), Yi Shen (2), Yan Yu (2), Hui-Chen Ho (4), Lan Liu (3), Yu-Rong Wu (5), Sun Chen (5), Xiao-Qing Liu(2), Kwang-Jen Hsiao (1)
Preventive Medicine Foundation, Taipei, Taiwan (1); Depts. of Pediatrics (2) and Ultrasonography (3), Xin Hua Hospital affiliated to Shanghai Jiao Tong University School of Medicine Chongming Branch, Shanghai, China; Taipei Institute of Pathology (4), Taipei, Taiwan; Dept. of Pediatric Cardiology (5), Xin Hua Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
Critical congenital heart diseases (CCHD) are severe and life-threatening diseases requiring surgical or catheter intervention within first year of life. Recently, pulse oximetry (POxS) was adopted for newborn screening of CCHD. A community-based newborn CCHD screening program was developed for Chongming Island, which is a remote county located in Shanghai, China. The birthing facilities on the Island are located about 90km (~2 hr traffic time) from the city referral medical centers and without any pediatric cardiologist on the Island.
Two birthing facilities were participated in this program between 2014.8 and 2015.12. At the age of 24-36 hr, POxS tests were performed. A result decision chart and a CCHD Screening Assistant App <cchd.pmf.tw> were provided to assist result decision at bedside. If the newborn failed the screening test, after clinical examination the newborn was referred for an echocardiography by a local ultrasonographer immediately. The echocardiographs were reviewed by a pediatric cardiologist of the referral medical center via free WeChat App remotely.
Of 3,303 live births on the island during the period, 98.2% underwent POxS. Five (0.15%) newborns had failed the screening test. All the screen failed cases were referred and confirm diagnosed before 48 hr after birth. Four of them were confirmed as CCHD, 3 IAA and 1 single ventricle, one of them had diagnoses solely attributable to the CCHD screening. The other referred case was diagnosed with pulmonary dysfunction.
This efficient and effective community-based newborn CCHD screening program in Chongming Island successfully integrated screening and referral systems which provided a scheme for implementation of the newborn CCHD screening program in remote area without local pediatric cardiologist in China.