NJ Leads in Screening for Heart Defects in Infants

Beth Fitzgerald | November 10, 2011 | Health Care
A simple medical procedure, mandated by law, saved tiny Dylan Gordon's life

Credit: (Governor's Office/Tim Larsen)
Baby Dylan
A simple test is saving lives by finding defects in the tiniest of hearts. Called pulse oximetry, it’s the medical procedure that pointed to problems soon after Dylan Gordon was born two months ago at Newton Memorial Hospital.

Dylan was tested on September 1, the day after the screening became New Jersey law. A sensor was placed on his toe to measure oxygen in his blood. Low levels signal congenital heart disease, a common birth defect.

Studies have found that heart problems can be picked up before newborns show signs of disease, said Dr. Jeanne Craft, a pediatric intensive care physician at Saint Barnabas Medical Center in Livingston.

“For some of these heart lesions, early intervention is life saving,” Craft said.

Healthcare experts said New Jersey is a national leader in the range of diagnostic screenings it requires for newborns.

“We are pretty good — we certainly screen babies well,” said Craft, who is co-chair of the government affairs committee of the New Jersey chapter of the American Academy of Pediatrics. The federal Health and Human Services agency recommends about 60 tests for newborns; New Jersey added the pulse oximeter before it made the HHS list.

Dylan’s defect was corrected by surgery. Yesterday he was back at Newton Medical Center – this time for a press conference with Gov. Chris Christie, who signed the bill mandating the screening into law

“It’s a rare day when you know a piece of legislation you signed saved a life,” Christie said.

Dr. Ben Lee, a neonatologist at Newton Medical Center, said New Jersey stands out for its commitment to newborn screening.

There’s a demand due to the relatively high income and educational level of New Jersey residents who are “very strong minded and very aware,” he said.

But not every state screens newborns for heart defects or requires every federally recommended blood test. “There is variation because there is a cost associated with all these things,” Craft said.

The pulse oximetry test is among the least expensive, ranging from $5 to about $15. It costs several hundred dollars to perform the full battery of tests recommended by the federal government, several which can be performed with a single spot of blood, Craft said.

In New Jersey “we do tests that are accurate, and we do tests for which there is some evidence that the test actually makes a difference,” she said.

Pulse oximetry “is a smart test,” said David Knowlton, president of the New Jersey Health Care Quality Institute. “It is dirt cheap and non-invasive.”

Following New Jersey’s lead, Secretary of Health and Human Services Kathleen Sebelius added pulse oximetry to the list of recommended newborn screenings. Maryland and Indiana will implement the test next year. Other states considering the procedure include New York, Pennsylvania, Missouri, Tennessee, and Nebraska.

“New Jersey has always been a leader in newborn screening,” said Mary E. O’Dowd, the state Health Commissioner. “I hope that by setting an example, as New Jersey likes to do, we will make a difference for other states and for the children in those states.”