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PA Hospitals Now Required to Perform 'Pulse Oximetry' Test on Newborns

In Pennsylvania, newborns are screened for more than 40 conditions, but only six of these screenings are mandatory according to Dr. Robert Cicco, the associate director of the neonatal intensive care unit at West Penn Hospital.

However, a new law will add a seventh condition to that list, requiring hospitals to screen babies for severe heart disease using a pulse oximetry test.

“These are heart conditions that may not present immediately at birth, but may make the baby critically ill over the first week or so of life,” Cicco said. “And if we can identify those things, we can actually treat the kids before they get sick.”

Cicco said the vast majority of newborns have undergone this simple test for years now, but Act 94 will ensure that every baby in Pennsylvania is screened.

According to Cicco, who has treated babies that have not passed the test, the condition is rare – with one case found in maybe thousands of births – but it is life-threatening.

“You put a little gadget on both the hand and the foot and what it does is it measures the oxygen content of the blood,” Cicco said. “This is not an invasive thing, you may have seen this [when] you go to the doctor’s, it’s a little thing that has a light in it that you can clip to your finger, in our case we’d clip it to their foot or their wrist.”

The test detects how much hemoglobin in the bloodstream has oxygen attached to it.

According to Cicco, normally, more than 95 percent of the hemoglobin in the body has oxygen attached to it.

“There’s two things that we would be concerned about: one, if the oxygen saturation is below 95 percent,” Cicco said. “But it’s also a concern if there is a discrepancy between the oxygen content in both the upper extremity and the lower extremity.”

If the newborn does not pass the test, Cicco said they need to undergo evaluation to see why there is not a sufficient amount of oxygen in the blood – whether it could be because of a severe heart disease condition or something wrong with the lungs.

He said the baby would undergo an echocardiogram to see if its heart is structured properly.

Cicco said the law will not only help with detection on an individual basis, it will also help from a public health perspective.

“So that kids that are identified with this problem via these types of screenings are reported to the state so that we can track how many cases are we identifying that may not have been identified before and also identifying: are there any what we call ‘false positives’ with this?” Cicco said.

The legislation was signed by Gov. Tom Corbett and will go into effect this October.

Jess is from Elizabeth Borough, PA and is a junior at Duquesne University with a double major in journalism and public relations. She was named as a fellow in the WESA newsroom in May 2013.