x Abu Dhabi, UAESunday 23 July 2017

Heart tests for every newborn in Abu Dhabi

Universal neonatal heart screening is a first for the Gulf.

ABU DHABI // Every baby in the emirate will be screened for congenital heart defects from January.

The examination will replace current tests that miss nearly half of cases, putting babies at risk of death or developmental disabilities such as brain damage.

The tests will be introduced as part of the Health Authority-Abu Dhabi's (Haad) newborn screening programme and will be covered by insurance.

The procedure uses a light probe to measure the level of oxygen in the heart's red blood cells on the baby's right hand and right foot.

The examination is carried out just a day after birth and only takes three minutes.

If the level of oxygen in the blood is less than 95 per cent, or if there is more than a 3 per cent difference between the results from the hand and foot, the test is repeated three more times at hourly intervals.

Congenital anomalies account for almost three-quarters of infant deaths in the emirate. Abu Dhabi is the first place in the Gulf to implement universal screening - doing so before even the US, doctors say.

Dr Jennifer Moore, the section head for family and school health at Haad, said the screening would also be a useful means of collecting better data, which would "give us further insights and shape future interventions".

Currently, babies get a physical examination that checks their pulse and breathing rate. But that is unreliable, experts say, missing nearly half of heart defect cases.

Most babies who leave hospital with undetected serious heart defects die within the first two weeks, said Dr Gerard Martin, the senior vice president of the US Children's National Heart Institute, which is helping Haad train staff to conduct the screening.

Coupled with the physical test, the light probe, or"pulse oximetry", is about 95 per cent accurate.

"The human eye can't detect the drop in oxygen until the saturation level is less than 80 per cent," Dr Martin said. "That leaves a lot of babies between 80 per cent and 95 per cent that are at risk of leaving the hospital undetected."





Those who continue to show abnormal results are then sent for an echocardiogram (ECG), an ultrasound of the heart that looks at its structure and function.

"Some of the babies will have low oxygen levels because of lung diseases or infections," Dr Martin said. "So the ECG works as the confirmatory test to determine that it is heart disease that is causing the low oxygen."

The survival rate for children with heart disease who receive surgery is 98 per cent.

A pilot project run by Tawam and Corniche hospitals this year has already screened more than 5,500 children, finding four cases.

"This is only across two hospitals in a span of 11 months. Imagine the impact this will have in the long term when the programme is officially rolled out to 21 birthing facilities," said Dr Martin.

Abu Dhabi is the first place in the Gulf to implement universal screening - doing so before even the US, Dr Martin said.

The programme should save money, too. Earlier intervention will cut long-term care costs, and the probes cost just US$1 (Dh3.6) each - and most clinics already have them.

"If the child is healthy when they leave the hospital because they haven't suffered brain injury, then the cost to take care of that child over the ensuing years for society is less," said Dr Martin. "We're very excited about what this is going to do and the number of lives that will be saved."