The Joplin Globe, Joplin, MO

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December 30, 2013

Missouri to screen all newborns for heart defects

Missouri is preparing to start screening every newborn baby for congenital heart defects, although local medical personnel say they already have added the test to their list of checkup procedures for infants.

The screenings for critical congenital heart disease, an umbrella term for any number of heart defects that can cause developmental delays or death if left untreated, will be required under a new state law that takes effect Wednesday.

A congenital heart defect is a problem with the structure of the heart that is present at birth. There are no particular risk factors. Anyone can have a child who is born with a defect, according to the American Heart Association.

Out of every 1,000 births, nine babies are born with a congenital heart disorder, most of which are mild, the association said.

Many children born with heart defects don’t need treatment, but the most severe cases can require catheter procedures, surgery or heart transplants, according to the National Institutes of Health. Signs of severe defects in newborns include rapid breathing, fatigue, a blue tint to the skin and poor blood circulation, although many defects cause few or no symptoms at all, the agency said.

Those who work in pediatrics in Joplin said the new law won’t affect them, as they already have implemented the screenings — in some cases, more than a year ago — under guidelines from the American Academy of Pediatrics and the American Heart Association.

The screening is conducted on babies who are at least 24 hours old, usually right before they are set to go home with their parents, said Rhonda Olvera, a pediatric nurse practitioner with Mercy Pediatrics in Carthage.

The noninvasive test consists of wrapping a device around the baby’s limbs to measure the oxygen saturation of the blood, she said. Any abnormal readings could suggest a heart problem, she said.

More severe diagnoses, Olvera said, include hypoplastic left heart syndrome (a rare defect in which the left side of the heart is critically underdeveloped, according to the Mayo Clinic) and tetralogy of Fallot (a rare combination of defects that causes oxygen-poor blood to flow out of the heart, the clinic said). Early diagnosis of these defects could reduce the risk of serious illness or death of the child later in life, Olvera said.

Paul Petry, a pediatrician with Freeman Health System, said the test is designed to be only an indicator of whether further testing is necessary.

“The test itself is just a screening test, which means we have to do other tests to have a definitive diagnosis,” Petry said. “It’s just one more tool we use to make sure the baby is OK to go home.”

The state Department of Health and Senior Services said an estimated 140 babies are born in Missouri each year with a congenital heart defect. Department officials hope the tests will prevent babies from being sent home with the risk of developing serious complications in the first few weeks of life.

In addition to Missouri, more than 30 other states have added critical congenital heart disease to the list of disorders for which newborns are screened. Newborns in the state are also routinely screened for cystic fibrosis, thyroid problems, their hearing and a number of metabolic disorders.

The new law is named for 5-year-old Chloe Manz, a Kansas City-area girl who was born in 2008 with a rare congenital heart defect that was discovered through a screening just nine hours after her birth; the screening was not mandatory at that time.

Efforts to enact the law over the past four years were spearheaded by Chloe’s mother, Kelly Manz.

“It still haunts me to this day — the thought that we would’ve been sent home with Chloe and her four undetected heart defects, and who knows what would have happened?” Manz wrote on her website in May, shortly before the law was signed by the governor. “It’s actually a comfort knowing that all Missouri hospitals will be adding this easy, painless, fast and life-saving screening to their list.”

THE ASSOCIATED PRESS contributed to this report.


CONGENITAL HEART DEFECTS are the most common type of birth defect, according to the Centers for Disease Control and Prevention. Thanks to advanced methods of diagnosis and treatment, individuals who are born with a heart defect are living longer than ever. An estimated 1 million adults in the U.S. are living with a congenital heart defect, the CDC said.

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