POX Range and the Threshold for Screening Major CHD in Neonates at Different Altitudes

Children's Hospital of Fudan University2,200 enrolled

Overview

major CHD (Congenital Heart Disease) screening by POX (pulse oximetry) in sea-level areas is not fit for low, medium and high altitude areas, but the normal range of pulse oximetry at different altitude areas has not been studied before, so the current screening technology can only be used in sea-level areas, but not for newborns in low, medium and high altitude areas. We need to carry out a research to clarify the range of POX and make sure the threshold of POX in major CHD screening in different altitude areas of China.

At present, the application of POX (pulse oximetry) in screening major CHD (congenital heart disease ) has been legislated in the United States. In China, the two indicators of POX plus auscultation of heart murmur for screening major CHD have also been promoted as national standards. There are differences in the POX range of newborns at different altitude areas, so the threshold of POX screening based on sea-level areas is not applicable to low, medium and high altitude areas. While the normal range of POX at different altitude areas has not been studied in detail, so the current screening strategy can only be used in sea-level areas, but not benefit newborns in low, medium and high altitude areas. In order to apply major CHD screening strategy better to cover the newborns all over the country, we need to clarify the range of POX at different altitude areas of China and make sure the threshold of POX in major CHD screening. We plan to carry out a multicenter study on the normal POX value range of healthy and asymptomatic term newborns 6-72 hours after delivery in medical centers with altitude of 500-1000; 1000-2000; 2000-3000; 3000-4000 and above 4000 meters. And compare the POX value at different altitude areas with that of newborns delivered in the maternity hospitals at sea level. And measure the POX value of newborns with major CHD in the same way. POX screening thresholds will be obtained at different altitude areas. We will test the hypothesis that POX of healthy newborns at different altitude areas is lower than that of healthy newborns at sea level, and POX threshold of major CHD screening is lower than that of sea level.

Study Type

OBSERVATIONAL

Enrollment

2,200

Conditions

Outcomes

Primary Outcomes

Pulse oximetry of healthy newborns at 6th hour after birth at different altitudes

Pulse oximetry of healthy newborns at 6th hour after birth would be measured by monitor at 6th hour after birth and would be described by range interquartile in healthy neonates in hospitals with different altitudes. Altitude levels :sea level, within 1000 meters above sea level, 1000 to 2000 meters above sea level, 2000 to 3000 meters above sea level, 3000 to 4000 meters above sea level and 4000 to 5000 meters above sea level.

Time frame: At 6th hours after birth

Secondary Outcomes

Pulse oximetry of healthy newborns at 12th hour after birth at different altitudes

Pulse oximetry of healthy newborns at 12th hour after birth would be measured by monitor at 12th hour after birth and would be described by range interquartile in healthy neonates in hospitals with different altitudes. Altitude levels :sea level, within 1000 meters above sea level, 1000 to 2000 meters above sea level, 2000 to 3000 meters above sea level, 3000 to 4000 meters above sea level and 4000 to 5000 meters above sea level.

Time frame: At 12th hours after birth

Pulse oximetry of healthy newborns at 24th hour after birth at different altitudes

Pulse oximetry of healthy newborns at 24th hour after birth would be measured by monitor at 24th hour after birth and would be described by range interquartile in healthy neonates in hospitals with different altitudes. Altitude levels :sea level, within 1000 meters above sea level, 1000 to 2000 meters above sea level, 2000 to 3000 meters above sea level, 3000 to 4000 meters above sea level and 4000 to 5000 meters above sea level.

Time frame: At 24th hours after birth

Pulse oximetry of healthy newborns at 48th hour after birth at different altitudes

Pulse oximetry of healthy newborns at 48th hour after birth would be measured by monitor at 48th hour after birth and would be described by range interquartile in healthy neonates in hospitals with different altitudes. Altitude levels :sea level, within 1000 meters above sea level, 1000 to 2000 meters above sea level, 2000 to 3000 meters above sea level, 3000 to 4000 meters above sea level and 4000 to 5000 meters above sea level.

Time frame: At 48th hours after birth

Pulse oximetry of healthy newborns at 72th hour after birth at different altitudes

Pulse oximetry of healthy newborns at 72th hour after birth would be measured by monitor at 72th hour after birth and would be described by range interquartile in healthy neonates in hospitals with different altitudes. Altitude levels :sea level, within 1000 meters above sea level, 1000 to 2000 meters above sea level, 2000 to 3000 meters above sea level, 3000 to 4000 meters above sea level and 4000 to 5000 meters above sea level.

Time frame: At 72th hours after birth

Pulse oximetry of newborns with critical congenital heart disease at 6th hour after birth at different altitudes

Pulse oximetry of critical congenital heart disease newborns at 6th hour after birth would be measured by monitor at 6th hour after birth and would be described by range interquartile in critical congenital heart disease neonates in hospitals with different altitudes. Altitude levels :sea level, within 1000 meters above sea level, 1000 to 2000 meters above sea level, 2000 to 3000 meters above sea level, 3000 to 4000 meters above sea level and 4000 to 5000 meters above sea level.

Time frame: At 6th hours after birth

Pulse oximetry of newborns with critical congenital heart disease at 12th hour after birth at different altitudes

Pulse oximetry of critical congenital heart disease newborns at 12th hour after birth would be measured by monitor at 12th hour after birth and would be described by range interquartile in healthy neonates in hospitals with different altitudes. Altitude levels :sea level, within 1000 meters above sea level, 1000 to 2000 meters above sea level, 2000 to 3000 meters above sea level, 3000 to 4000 meters above sea level and 4000 to 5000 meters above sea level.

Time frame: At 12th hours after birth

Pulse oximetry of newborns with critical congenital heart disease at 24th hour after birth at different altitudes

Pulse oximetry of critical congenital heart disease newborns at 24th hour after birth would be measured by monitor at 24th hour after birth and would be described by range interquartile in critical congenital heart disease neonates in hospitals with different altitudes. Altitude levels :sea level, within 1000 meters above sea level, 1000 to 2000 meters above sea level, 2000 to 3000 meters above sea level, 3000 to 4000 meters above sea level and 4000 to 5000 meters above sea level.

Time frame: At 24th hours after birth

Pulse oximetry of newborns with critical congenital heart disease at 48th hour after birth at different altitudes

Pulse oximetry of critical congenital heart disease newborns at 48th hour after birth would be measured by monitor at 48th hour after birth and would be described by range interquartile in critical congenital heart disease neonates in hospitals with different altitudes. Altitude levels :sea level, within 1000 meters above sea level, 1000 to 2000 meters above sea level, 2000 to 3000 meters above sea level, 3000 to 4000 meters above sea level and 4000 to 5000 meters above sea level.

Time frame: At 48th hours after birth

Pulse oximetry of newborns with critical congenital heart disease at 72th hour after birth at different altitudes

Pulse oximetry of critical congenital heart disease newborns at 72th hour after birth would be measured by monitor at 72th hour after birth and would be described by range interquartile in critical congenital heart disease neonates in hospitals with different altitudes. Altitude levels :sea level, within 1000 meters above sea level, 1000 to 2000 meters above sea level, 2000 to 3000 meters above sea level, 3000 to 4000 meters above sea level and 4000 to 5000 meters above sea level.