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Screening for Infant and Neonatal Congenital Heart Disease

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Please help discuss the role of the NHS Newborn and Infant Physical Examination Programme in improving health outcomes for children
- I am focusing specifically on CHD.
- My school is in the UK so discussion must be relevant to UK healthcare (ie NHS is National Health Service and Primary care is delivered by General Practice (GP).

Introduction
Congenital Heart Disease (CHD) has an incidence of approximately 600 per 100,000 live births for the moderate and severe forms of the disease. Approximately 18 per 100,000 are classed as Critical Congenital Heart Disease and require surgical intervention within the first year of life. It is therefore important that cases that have not been identified prenatally are detected early in the child's life.

Description: The Infant Physical Examination Programme at Parkgate Medical Centre (GP) (less than 100 words)
The NHS Newborn and Infant Physical Examination Programme is aimed at screening for congenital diseases. The most important of these are congenital cataracts, CHD, undescended testicles and developmental hip dysplasia. Newborns undergo a physical examination within 72 hours of birth and a second one at six to eight weeks of age. At Parkgate Medical Centre the six to eight week check is performed by the GPs.

Public Health Aspects
Health Economics - Early identification saves NHS money?
Rather than checking only babies with risk factors, are all babies are checked?
Health inequalities?
Discussion: Does the Infant Physical Examination in the primary care setting improve health outcomes for children?

Some sources I've found:
http://newbornphysical.screening.nhs.uk/nationalprogramme
http://www.geneticseducation.nhs.uk/mededu/identifying-those-at-risk/national-screening-programmes
http://newbornphysical.screening.nhs.uk/evidence
http://www.england.nhs.uk/wp-content/uploads/2014/05/chd5-early-detection-chd.pdf
http://www.chphc.org/hostedsites/Documents/CHD_Webinar_021412.pdf
http://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/PEHDIC/Pages/Newborn-Screening-for-CCHD.aspx
http://www.cdc.gov/ncbddd/heartdefects/data.html
http://www.uptodate.com/contents/congenital-heart-disease-chd-in-the-newborn-presentation-and-screening-for-critical-chd

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Solution Summary

The discussion focuses on the importance of improving outcomes for infants with CHD, through early detection and screening programs. An argument about why more frequent screening in the early weeks after delivery is needed, is discussed, in terms of improved outcome, reduced cost, and overall reduction of infant mortality.

Solution provided by:
Beatrice Martino, MEd
Education
  • MEd, Jones International University
  • BSc, DeVry University
  • MPH, Walden University
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