The hearing test and the oxygen test
Two quick screens, and what a "refer" actually means.
Hearing. Coverage rose from 52% of US newborns in 2000 to more than 97% by 2014. In 2022 CDC data covering 2,832,143 screened infants, 98.4% passed the initial screen and 1.6% did not. A result of "refer" on the first screen usually means fluid or movement, not deafness. Most babies who do not pass initially pass on repeat.
Pulse oximetry. A sensor measures oxygen levels to detect critical congenital heart defects. Across 21 studies and 457,202 newborns, sensitivity was 76.3% and specificity 99.9%, with a false-positive rate of 0.14%. Testing after 24 hours of age gave far fewer false alarms than testing before 24 hours: 0.05% against 0.50%.
What that sensitivity figure meansThe oxygen test finds roughly three quarters of critical heart defects. One in four is missed. A normal result is reassuring but is not a guarantee, which is worth knowing if your baby later seems unwell.
Where this comes from:
247. Thangaratinam S, Brown K, Zamora J, Khan KS, Ewer AK. Pulse oximetry screening for critical congenital heart defects in asymptomatic newborn babies: a systematic review and meta-analysis. Lancet. 2012;379(9835):2459-2464.
248. Plana MN, Zamora J, Suresh G, Fernandez-Pineda L, Thangaratinam S, Ewer AK. Pulse oximetry screening for critical congenital heart defects. Cochrane Database Syst Rev. 2018;(3):CD011912.
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This page is educational. It supports the conversation with your own clinicians. It is not consent to any treatment, and it cannot assess you. If you are worried about a symptom now, see urgent warning signs.