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Pulse oximetry screening for congenital heart defects in newborn infants: an evaluation of acceptability to mothers
  1. Rachael Powell1,
  2. Helen M Pattison1,
  3. Abhay Bhoyar2,
  4. Alexandra T Furmston3,
  5. Lee J Middleton3,
  6. Jane P Daniels3,
  7. Andrew K Ewer4,5
  1. 1School of Life and Health Sciences, Aston University, Birmingham, UK
  2. 2Department of Paediatric Cardiology, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, UK
  3. 3Birmingham Clinical Trials Unit, University of Birmingham, Birmingham, UK
  4. 4School of Clinical and Experimental Medicine, University of Birmingham, Birmingham, UK
  5. 5Neonatal Unit, Birmingham Women's Healthcare NHS Foundation Trust, Birmingham, UK
  1. Correspondence to Dr Rachael Powell, School of Life and Health Sciences, Aston University, Aston Triangle, Birmingham B4 7ET, UK; r.k.powell{at}


Background Introducing neonatal screening procedures may not be readily accepted by parents and may increase anxiety. The acceptability of pulse oximetry screening to parents has not been previously reported.

Objective To assess maternal acceptability of pulse oximetry screening for congenital heart defects and to identify factors predictive of participation in screening.

Design and setting A questionnaire was completed by a cross-sectional sample of mothers whose babies were recruited into the PulseOx Study which investigated the test accuracy of pulse oximetry screening.

Participants A total of 119 mothers of babies with false-positive (FP) results, 15 with true-positive and 679 with true-negative results following screening.

Main outcome measures Questionnaires included measures of satisfaction with screening, anxiety, depression and perceptions of test results.

Results Participants were predominantly satisfied with screening. The anxiety of mothers given FP results was not significantly higher than that of mothers given true-negative results (median score 32.7 vs 30.0, p=0.09). White British/Irish mothers were more likely to participate in screening, with a decline rate of 5%; other ethnic groups were more likely to decline with the largest increase in declining being for Black African mothers (21%, OR 4.6, 95% CI 3.8 to 5.5). White British mothers were also less anxious (p<0.001) and more satisfied (p<0.001) than those of other ethnicities

Conclusions Pulse oximetry screening was acceptable to mothers and FP results were not found to increase anxiety. Factors leading to differences in participation and satisfaction across ethnic groups need to be identified so that staff can support parents appropriately.

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  • Collaborators Members of the PulseOx Study Group: K S Khan and S Thangaratinam (Barts and the London School of Medicine), J J Deeks (University of Birmingham), A M Tonks, West Midlands Perinatal Institute, UK; S Hooper and S Caranci Birmingham Women's NHS Foundation Trust UK; P Satodia and C Hill-Evans, University Hospitals Coventry and Warwickshire NHS Trust, UK; S Deshpande, S Mehta and S Ward, The Shrewsbury and Telford Hospital NHS Trust, UK; B Kumaratne and K Cheshire, The Royal Wolverhampton Hospitals NHS Trust, UK; S Sivakumar and M King, Sandwell and West Birmingham Hospitals NHS Trust, UK; R Mupanemunda and D Mellers, Heart of England NHS Foundation Trust, UK. The PulseOx Study was coordinated by Birmingham Clinical Trials Unit at the University of Birmingham and we acknowledge the work of all the staff involved in the study, especially Leanne Fulcher, who was the data manager, and Edward Tyler who designed and developed the study database. We thank all the community and hospital midwives, midwifery assistants and nursing staff who conducted recruitment and screening. We are particularly grateful to all the women who participated.

  • Funding National Institute for Health Research Health Technology Assessment (NIHR HTA) programme.

  • Competing interests None.

  • Ethics approval Trent Research Ethics Committee ref:07/MRE04/40.

  • Provenance and peer review Not commissioned; externally peer reviewed.