Newborn Heart Screenings
Introduction
Congenital heart defects (CHDs) are the most common type of birth defect, affecting approximately 1 in 100 babies. While some congenital heart defects are minor and may resolve on their own, others—known as critical congenital heart defects—can be life-threatening if not identified and treated early. These critical conditions affect approximately 1 in 4 babies born with a congenital heart defect.
What Causes Heart Defects?
There are many different types of CHD, including:
- A hole between two chambers in the heart
- A problem with one of the heart valves
- More complex problems, where one side of the heart hasn’t grown properly
- Problems with the large blood vessels leading the heart
With many types, there are therefore many possible causes.
Some known causes are linked to genetic conditions, such as:
- Down’s syndrome
- Maternal illnesses and existing conditions (such as Type 1 diabetes)
- Rare metabolic disorders (such as phenylketonuria (PKU))
However, in many cases, the cause of a heart defect is unknown.
Scans & Screenings to Identify CHDs in Newborns
Prenatal: Foetal anatomy scan (ultrasound)
Increasingly, a large number of CHDs are being detected antenatally through a foetal anatomy scan, particularly if this is combined with a four-chamber view of the heart and a view of the outflow tracts of the heart (the major vessels that leave the heart). These scans examine the structure of the baby’s heart and assess how blood is flowing through it. The foetal anatomy scan (ultrasound) is typically carried out between 20 and 22 weeks’ gestation. This is now regarded as standard scanning practice.
These antenatal tests can be life-saving for babies, particularly those with critical CHDs. For example, if an anomaly is detected, it enables further testing—such as a foetal echocardiogram (an ultrasound of the heart; this test is generally strongly recommended for mothers with pre-existing genetic conditions, such as Type 1 diabetes)—as well as allowing families and healthcare teams to plan appropriate care, even before the baby is born. In some cases, in Cayman, this may mean planning for the mother to give birth overseas at a hospital with more specialist care and treatment.
It is important to note that not all CHD cases can be diagnosed or detected before birth. Some conditions may not become apparent until after birth.
That’s where newborn heart screening plays a vital role.
Within 24-48 hours of birth: Newborn Heart Screenings
In many countries, including here in Cayman, we carry out postnatal newborn screenings to look for CHDs—to pick up anything that potentially can’t be heard by a doctor or seen by simply looking at a baby’s chest. Newborn heart screenings are quick, safe, and painless tests usually performed within the first 24 to 48 hours after birth.
The test measures the oxygen levels in a baby’s right arm and in one of their feet. A low reading—or a significant difference between the two readings—may signal an underlying heart problem.
The test takes just a few minutes, but it can make a lifetime of difference and ensure a baby gets the right treatment and care as early as possible.
How You Can Help
At the Cayman Heart Foundation, we are committed to raising awareness about CHDs, prenatal and newborn heart screenings, and supporting families affected by congenital heart disease.
Your support helps us to:
- Promote early detection across the islands
- Provide education for parents and healthcare professionals
- Advocate for improved care pathways locally and regionally
- Support families of children with congenital heart disease to be with their child when receiving hospital care
