Newborn Congenital Heart Disease Screening

Congenital Heart Disease Screening Program Toolkit (pdf)
Newborn Screening Protocol (pdf)

In February 2011, Senate Bill 0552 was passed requiring that, effective January 1, 2012, newborns must be given a pulse oximetry screening examination to detect for low oxygen levels. SB0552 is also known as Cora's Law and was named for Cora Mae McCormick, who died suddenly and unexpectedly in her mother's arms on December 6, 2009, of an undetected congenital heart defect.

Cora Mae McCormick

Kristine Brite McCormick had received excellent prenatal care, and her pregnancy, labor, and delivery were healthy. Cora's Apgars were both 9s, and she exhibited no symptoms of any coronary problems. At only five days old, Cora slipped away while breastfeeding.

"I'll continue to work to spread Cora's story forever."
After her devastating loss, Kristine focused her efforts on sharing Cora's story to raise awareness of congenital heart defects, enlisting the help of Senator Brent Waltz to draft SB0552. With the 2012 implementation of the newborn screening guidelines, her efforts have paid off, and Cora's legacy to spread awareness of congenital heart defects is secured. As pediatric care providers, the ball is now in our court.

As you may know, effective January 1, 2012, all birthing facilities in Indiana will be required to perform pulse oximetry newborn screening to detect critical congenital heart defects (CCHD).

The Need for Newborn Screening

Infants with congenital heart defects have abnormalities in their heart structure and function due to abnormal heart development prior to birth. Infants with the most serious form of congenital heart defects, CCHD, have structural heart defects that are often associated with hypoxia during the newborn period, and these infants are at a greater risk of morbidity and mortality if not diagnosed soon after birth.

About Pulse Oximetry

Pulse oximetry screening is a simple, non-invasive, and painless procedure used to measure the percentage of oxygen in the blood, and it has been determined to be an effective screening for congenital heart defects in newborns. Indiana is one of only three states that have passed legislation requiring pulse oximetry screening of all newborns.

The Indiana pulse oximetry newborn screening protocols pertain to healthy infants, defined as those born 35+ weeks gestation. Specific recommendations for the newborn screen include the following:

  • Perform pulse oximetry screening no earlier than 24 hours of age.
  • Infants with saturation < 90% in the right hand or foot should be immediately referred for clinical assessment.
  • Infants with three failed readings—defined as oxygen saturation measurements < 95% in both extremities or > 3% difference between both extremities—should also receive a clinical assessment.
    • An echocardiogram should then be performed and interpreted by a pediatric cardiologist to exclude CCHD before the infant is discharged home.
    • A referral to a pediatric cardiologist is warranted immediately if symptomatic or in a timely manner if asymptomatic.
  • To be compliant with Indiana's newborn screening law, all infants in the NICU should receive either pulse oximetry screening or an echocardiogram prior to discharge.

St.Vincent Women's Hospital is one of only two centers in Indiana with pediatric cardiac surgeons who specialize in the surgical repair of congenital heart defects. Our highly trained neonatal transport team is crucial in providing uninterrupted care in a mobile NICU environment.

For facilities not equipped with an echocardiogram, St.Vincent Women's Hospital can provide newborn transport to our facility through our ONE Call Transfer (317-338-5000). For facilities who conduct their own echocardiograms, should there be an emergent finding requiring follow-up care at a hospital facility, our transport team is well-qualified to manage these potentially critically ill newborns.

About ONE Call Transfer

Staffed with specially trained neonatal physicians, neonatal nurse transport specialists, neonatal respiratory therapists and EMTs, our newborn transport team is available to transport and provide the highest level of care for even the most critical infants. High-risk neonates transported to St.Vincent Hospital also have access to pediatric subspecialty services at Peyton Manning Children’s Hospital at St.Vincent, including The Children’s Heart Center and its program for infants and children with heart disease, as well as a full range of pediatric subspecialty services.