Mandatory newborn screening policies for critical congenital heart disease (CHD) were associated with a significant reduction in infant deaths compared to states without these policies, according to a study published Dec. 5 in the Journal of the American Medical Association.

Rahi Abouk, PhD, et al., conducted an observational study to assess the number of early infant deaths (24 hours and six months of age) for critical CHD or other congenital cardiac causes, gathered by the National Center for Health Statistics’ linked birth and infant death data set for each state-month birth cohort from 2007 – 2013.

As of June 1, 2013, eight states had implemented mandatory CHD screening policies, five had voluntary screening policies and nine had adopted but not yet implemented mandatory policies.

Results showed that between 2007 – 2013, there were 2,734 deaths due to critical CHD and 3,967 deaths due to other or unspecified cardiac causes. Death rates due to critical CHD in states with mandatory screening policies were 8.0 (95 percent confidence interval (CI), 5.4 – 10.6) per 100,000 births in 2007, and 6.4 (95 percent CI, 2.9 – 9.9) per 100,000 births in 2013.

Additionally, results showed that state adoption of a mandatory newborn screening policy was associated with a significant decline of 33.4 percent (95 percent CI, 10.6 percent – 50.3 percent) in death rates due to critical CHD versus states without the policy, with an absolute decline of 3.9 (95 percent CI, 3.6 – 4.1) deaths per 100,000 births.

The authors conclude that no significant decrease was found in critical CHD and infant deaths for states with nonvoluntary screening policies.

In an accompanying editorial comment, Alex R. Kemper, MD, MPH, MS, et al., note that “although important unanswered questions remain about the comparative effectiveness of different screening approaches, the evidence presented by Abouk and colleagues is reassuring that adopting a policy mandate for critical CHD newborn screening has saved lives.”

In encouraging news, 47 states and the District of Columbia now have mandatory screening policies in place. The College's State Advocacy staff, working with ACC Chapters, have played a major role in both advocating for and implementing mandated CCHD screening across the country.

Keywords: Infant, Infant, Newborn, Neonatal Screening, Mandatory Testing, National Center for Health Statistics, U.S., Confidence Intervals, Infant Mortality, Adoption, Cohort Studies, Heart Diseases

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