Evaluation of Pulse Oximetry Screening Rates Among the Midwife‐Attended Out‐of‐Hospital Birth Community in Michigan

Abstract

Introduction:In Michigan, pulse oximetry screening rates for critical congenital heart defects (CCHDs) are assessed for birthing hospitals but have not been assessed for the midwife-attended births that occur in the out-of-hospital birth community. This analysis was conducted to determine pulse oximetry screening rates among the midwife-attended out-of-hospital birth community in Michigan overall, and among midwives provided with loaned pulse oximeters from the Michigan Department of Health and Human Services (MDHHS). Methods:Records for midwife-attended out-of-hospital births between April 1, 2014, and December 31, 2016, were linked via probabilistic matching with newborn screening records. Pulse oximetry screening rates were calculated for the midwife-attended out-of-hospital birth population overall, by midwife, and stratified by receipt of loaned pulse oximeters from MDHHS. Births from midwives who attended 5 or more nonhospital births during the study period were included in this analysis. Results:Of the 3410 midwife-attended out-of-hospital births, 20.8% (n = 710) reported as having received a pulse oximetry screening for CCHDs. For births attended by midwives who received pulse oximeters from MDHHS, 50.5% had pulse oximetry screening results reported, compared with 12.7% among births attended by midwives without a loaned pulse oximeter. Of the 78 total midwives, 18% (n = 14) reported pulse oximetry screening results on more than half of the births they attended. Of the 14 midwives who received a pulse oximeter from MDHHS, 50.0% (n = 7) reported screening results for more than half of all births they attended. Discussion:Our findings indicate that CCHD screening rates are low among midwife-attended out-of-hospital birth community. Screening rates were higher among midwives who received a pulse oximeter from MDHHS, but fewer than half of the attended births had a reported pulse oximetry screening. Further discussions with the midwife-attended out-of-hospital birth community to better understand screening barriers may be beneficial.

Pulse oximetry test for screening congenital heart diseases: a systematic review

“…An effective test was configured for this context, which is especially important, given that the newborn is without clinical-hospital supervision. However, in this scenario, difficulties arise such as the cost of equipment, lack of professional training, and time required for retests, according to the protocol (54) . In this context, the possibility of portable oximeters, even with applications on cell phones, as a guide for performance and interpretation of results, would offer a reduction in costs and higher quality of screening (55) .…”

Teste de oximetria de pulso para triagem de cardiopatias congênitas: revisão sistemática

“…Configurou-se um teste efetivo para esse contexto, o que é especialmente importante, visto que o recémnascido está sem supervisão clínica-hospitalar. No entanto, neste cenário, apresentam-se dificuldades como custo do equipamento, falta de capacitação profissional e tempo necessário para retestes, conforme o protocolo (54) . Neste contexto, a possibilidade de oxímetros portáteis, até mesmo com aplicativos em celulares, como guia para performance e interpretação dos resultados, ofereceria redução nos custos e maior qualidade da triagem (55) .…”