TITLE:
Pulse Oximetry Screening for Congenital Heart Disease in Newborns: Performance in Brazzaville Hospitals
AUTHORS:
Aymar Pierre Gildas Oko, Neli Yvette Ngakengni, Judicaël Kambourou, Lorna Frangella Kanga, Flora Nombo Mavoungou, Leticia Lombet, Georges Marius Moyen
KEYWORDS:
Performance, Pulse Oximetry, Neonatal Screening, Congenital Heart Disease, Brazzaville Maternity Wards
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.16 No.2,
March
10,
2026
ABSTRACT: Background: While pulse oximetry is a well-established screening tool for the early detection of congenital heart disease (CHD) in newborns, its diagnostic performance and feasibility have not been evaluated in the Republic of the Congo. Objective: The aim is to analyse the performance of pulse oximetry in screening for congenital heart disease in newborns in hospitals in Brazzaville, comparing its accuracy in detecting all congenital heart diseases versus cyanotic congenital heart diseases. Methods: We conducted a two-stage, multicenter, cross-sectional study from March 1 to August 31, 2022. Mother-newborn dyads were enrolled post-delivery. All included newborns underwent pulse oximetry screening, followed by confirmatory Doppler echocardiography as the diagnostic gold standard. Sociodemographic, reproductive, and clinical data were collected. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of pulse oximetry screening were calculated. Results: We included 300 mother-newborn dyads. Mothers were predominantly aged 20 - 34 years (73%). Newborns were mostly male (54.3%) and term (75%). Screening was performed at 12 - 24 hours of life in 55.3% of cases and at 24 - 72 hours in 44.7%. Twelve cases of CHD were diagnosed: atrial septal defect (n = 4), ventricular septal defect (n = 2), complete atrioventricular canal (n = 2), tetralogy of Fallot (n = 2), truncus arteriosus (n = 1), and double outlet right ventricle (n = 1). For detecting all CHD, pulse oximetry showed a sensitivity of 41.7%, specificity of 86.8%, PPV of 11.6%, and NPV of 97.2%. For cyanotic CHD specifically, its performance was superior, with 100% sensitivity, 86.7% specificity, 9.3% PPV, and 100% NPV. Conclusion: In our setting, pulse oximetry proved to be a highly sensitive and reliable screening tool for cyanotic forms of congenital heart disease. These findings support its potential utility in routine neonatal care. Further large-scale studies are warranted to inform policies for its systematic implementation across Congolese maternity units.