Comparison Of The Accurancy Of Prenatal And Postnatal Screening For The Detection Of Congenital Heart Disease : Systematic Review
DOI:
https://doi.org/10.20956/nmsj.v11i1.48088Abstract
Introduction: Congenital heart disease (CHD) is one of the most common congenital anomalies and remains a leading cause of neonatal morbidity and mortality worldwide. Early detection through prenatal and postnatal screening plays a crucial role in improving clinical outcomes; however, the diagnostic accuracy of these screening approaches varies across studies. Method: This systematic review was conducted and reported in accordance with the PRISMA 2020 guidelines. A comprehensive literature search was performed in PubMed, Embase, Web of Science, and the Cochrane Library up to December 20, 2025. Title, abstract, and full-text screening were independently conducted by two reviewers, with disagreements resolved through discussion. Eligible studies were English-language articles published between 2015 and 2025 that reported the diagnostic accuracy of prenatal screening (ultrasonography or fetal echocardiography) and/or postnatal screening (pulse oximetry or clinical examination) for CHD detection. Risk of bias and methodological quality were assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. Due to substantial heterogeneity among studies, data were synthesized narratively. Conclusions: Prenatal and postnatal screening methods exhibit complementary strengths in the detection of CHD. The implementation of an integrated two-stage screening strategy (prenatal–postnatal) is recommended as an optimal approach to enhance early detection and reduce neonatal morbidity and mortality associated with CHD, particularly in low- and middle-income countries.
References
1. Morton, S. U., Quiat, D., Seidman, J. G. & Seidman, C. E. Genomic frontiers in congenital heart disease. Nat. Rev. Cardiol. 19, 26–42 (2022).
2. Sood, E. et al. Neurodevelopmental outcomes for individuals with congenital heart disease: updates in neuroprotection, risk-stratification, evaluation, and management: a scientific statement from the American Heart Association. Circulation 149, e997–e1022 (2024).
3. Amdani, S. et al. Evaluation and management of chronic heart failure in children and adolescents with congenital heart disease: a scientific statement from the American Heart Association. Circulation 150, e33–e50 (2024).
4. Sun, H. Y. Prenatal diagnosis of congenital heart defects: echocardiography. Transl. Pediatr. 10, 2210 (2021).
5. Tomek, V. et al. Pregnancy termination and postnatal major congenital heart defect prevalence after introduction of prenatal cardiac screening. JAMA Netw. open 6, e2334069–e2334069 (2023).
6. Mamalis, M. et al. Comparison of the Results of Prenatal and Postnatal Echocardiography and Postnatal Cardiac MRI in Children with a Congenital Heart Defect. J. Clin. Med. 12, 1–10 (2023).
7. Lee, E. et al. Sensitivity and Specificity of Second-Trimester Anatomy Ultrasound for Detection of Fetal Congenital Heart Disease. Ultrasound Obstet. Gynecol. 62, 252 (2023).
8. Plana, M. N. et al. Pulse oximetry screening for critical congenital heart defects. Cochrane Database Syst. Rev. (2018) doi:10.1002/14651858.CD011912.pub2.
9. Singh, Y. & Chen, S. E. Impact of pulse oximetry screening to detect congenital heart defects: 5 years’ experience in a UK regional neonatal unit. Eur. J. Pediatr. 181, 813–821 (2022).
10. Janjua, D., Singh, J. & Agrawal, A. Pulse oximetry as a screening test for congenital heart disease in newborns. J. Mother Child 26, 1–9 (2022).
11. Murni, I. K. et al. Feasibility of screening for critical congenital heart disease using pulse oximetry in Indonesia. BMC Pediatr. 22, 4–11 (2022).
12. Majani, N. G. et al. Pulse oximetry screening for critical congenital heart disease in Tanzanian newborns: Diagnostic accuracy, sensitivity, and specificity in a low-resource healthcare setting. PLOS Glob. Public Heal. 5, 1–13 (2025).
13. Slitine et al. Pulse Oximetry and Congenital Heart Disease Screening : Results of the First Pilot Study in Morocco. 1–7 (2020).
14. Jullien, S. Newborn pulse oximetry screening for critical congenital heart defects. BMC Pediatr. 21, 1–9 (2021).
15. Jawin, V., Ang, H. L., Omar, A. & Thong, M. K. Beyond critical congenital heart disease: Newborn screening using pulse oximetry for neonatal sepsis and respiratory diseases in a Middle-Income Country. PLoS One 10, 1–13 (2015).
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Fadiyah Ulfah Khalid Fadiyah
This work is licensed under a Creative Commons Attribution 4.0 International License.
