Review Showed That Better Screening Is Still Needed for a Minority of Severe and Critical Congenital Heart Defects.

AIM: The review explored the effectiveness of different screening strategies for detecting severe and critical congenital heart defects (CHDs) before neonates were discharged from hospital after birth. These were prenatal fetal ultrasounds, postnatal pulse oximetry (POX), and clinical examinations. METHODS: This paper references studies that were published from 2005 to 2025, with a particular emphasis on those from Nordic countries. RESULTS: Prenatal detection rates of 42%-46% in live born infants were registered in nationwide studies. Pregnancy termination rates for severe or critical CHDs increased to 25%-43% and these influenced the prevalences and postnatal detection patterns of such defects. When CHDs that were detected prenatally were excluded, POX screening on the first day of life detected 11%-47% of severe and critical CHDs, depending on the inclusion criteria. When those detected by POX screening were excluded, routine clinical examinations identified 39%-58% of the cases in apparently healthy infants. The remainder were detected because of symptoms or some comorbidity. In infants born in 2014-20, 85%-89% of the severe and critical CHDs were found before discharge. CONCLUSION: Although most severe and critical CHDs were detected before discharge, there are still challenges with regard to developing better screening methods to reduce cases that have been missed.