On January 27th, it became mandatory in New York State to give a pulse oximetry test to each and every newborn. Governor Cuomo signed the Pulse Ox bill into law last August. The bill states that a newborn cannot be released from the hospital until they are given this important screening test. American Heart Association volunteers, pediatricians, parents, and policy makers are celebrating across the state because this bill could improve the lives of many children.
A pulse oximeter is used for performing this simple, non-invasive screening test. The purpose is to measure oxygen levels in the bloodstream. Low levels of oxygen in the blood are linked to congenital heart disease. This disease occurs in approximately 1% of newborns, which currently makes it the most common birth defect. Pulse oximeters can be used to detect heart defects in over 90% of cases.
Development & Causes
Heart development begins in about the fourth week of pregnancy. It starts as a single tubular structure, which grows and twists on itself over time. This process eventually produces the walls and chambers of the heart. Simultaneously, four valves begin to develop, which allow the heart to pump blood into the cardiac chambers, blood vessels, lungs, and the rest of the body.
During this important period, many factors can impact the development of the heart. Some of these factors are genetic and physiological, while others are environmental. The environmental factors include untreated diabetes, exposure to chemicals, and certain medications. In many individual cases, the causes of congenital heart disease are not known.
A fetus gets oxygen from the mother’s placenta, not its own lungs. This means that most heart conditions don’t cause difficulties until after birth, making them hard to detect during pregnancy. But the sooner a heart defect is diagnosed, the more time a medical professional has to treat and manage the condition.
Signs, Symptoms, & Treatment
Congenital heart disease can cause a wide range of symptoms in afflicted children, including stunted weight gain, heart murmurs, chronic lung infections, breathing difficulties, long congestion, restricted blood flow, and cyanosis (a condition which causes skin, fingernails, and lips to have a bluish tint). Any of these symptoms can make it difficult for children with congenital heart disease to live a normal life because it increases their risk of various medical conditions, makes it tough to exercise, and causes other problems.
In order to treat congenital heart disease, medication, surgeries, cardiac catheterization, angioplasty, and other procedures may be required. Many children with the disease have to continue seeing a cardiologist even as an adult. But by detecting congenital heart disease in newborns, it becomes easier to treat the condition early. This increases the likelihood of a successful intervention, therefore improving the quality of life in affected children.
The Pulse Ox bill represents a major achievement in pediatric and cardiac medicine, as well as New York legislation. Hopefully other states will follow suit soon and enact similar laws. Until then, pregnant mothers should ask their doctor for more information on pulse oximetry screening tests and infant congenital heart disease.