Infants Not Screened for Heart Disease at Birth, Despite Guidelines

The CDC recommends all infants receive heart disease and hearing loss screenings at birth.

A new report from the CDC found that many newborns are not receiving the recommended screenings for hearing loss and critical congenital heart disease (CCHD). The study also highlights the importance of these screenings.

The gaps shown in the report must be closed to ensure that children achieve optimal quality of life, according to the CDC.

Approximately 1 in 500 children are born with CCHD, including severe forms of congenital heart disease, which is the most common birth defect. Congenital heart disease accounts for more than 30% of infant deaths related to birth defects, according to the report.

Newborn screening identifies conditions that can impact long-term health and survival. The CDC states that the public health program benefits more than 4 million infants annually. The guidelines call for blood tests to search for numerous conditions and screening for hearing loss and CCHD.

“Newborn screening at birth is crucial to quickly identify infants at risk of hearing loss and congenital heart disease so they can receive early intervention and follow-up care,” said CDC Director Brenda Fitzgerald, MD. “Finding these conditions early can give infants the best chance to properly develop and lead healthy lives.”

The CDC projects that without screening, 875 newborns with CCHD were not diagnosed prior to being discharged from the birth facilities, according to the study. Now, many infants can be diagnosed by using pulse oximetry testing, which is non-invasive and painless.

For every 200 newborns with CCHD, at least 1 death due to the undiagnosed condition could be avoided if facilities screened infants with pulse oximetry testing, according to the study.

Permanent hearing loss affects nearly 2 per 1000 newborns, with most deemed to already have or be at risk of developmental delay. Infants who are diagnosed prior to 3 months of age and who receive intervention prior to 6 months of age have better language development than those who do not receive the services, according to the CDC.

The Early Hearting Detection and Intervention (EHDI) programs ensure that infants receive the recommended screenings and interventions. The federally-funded programs ensure that children are screened before age 1 month, and diagnosed before age 3 months, and receive intervention services before age 6 months.

Currently, there is no federal funding for CCHD screening services, despite the findings that show not detecting the condition can increase the risk of disability and death, according to the report.

“The collaboration between EHDI programs, health professionals, and parents has led to great progress on hearing loss screening and follow-up,” said Stuart K. Shapira, MD, PhD, chief medical officer and associate director for Science at CDC’s National Center on Birth Defects and Developmental Disabilities. “We must apply the same effort and resources to CCHD screening to help prevent infant deaths and offer children the greatest chance to thrive.”