Maternal acceptability of pulse oximetry screening at home after home birth or very early discharge

Abstract

The Netherlands has a unique perinatal healthcare system with a high rate of home births and very early discharge after delivery in hospital. Although we demonstrated that pulse oximetry (PO) screening for critical congenital heart disease is feasible in the Netherlands, it is unknown whether parents find the screening acceptable when performed in home birth setting. We assessed the acceptability of PO screening to mothers after screening in home setting. A questionnaire was sent electronically to mothers who gave birth and/or had postnatal care under supervision of a community midwife participating in the Pulse Oximetry Leiden Screening (POLS) study, a feasibility study of PO screening in the Dutch care system, performed in the Leiden region, the Netherlands. The questionnaire included questions based on satisfaction, general feelings, and perceptions of PO screening. A total of 1172/1521 (77%) mothers completed the questionnaire. Overall, mothers were happy with the performance of the test (95%), thought their baby was comfortable during the screening (90%) and did not feel stressed while the screening was performed (92%). Most mothers would recommend the test to others (93%) and considered the test important for all babies (93%). Conclusion: Mothers of newborns participating in the study found the PO screening acceptable when performed at home. What is Known:• Pulse oximetry screening for critical congenital heart defects is (cost)effective and acceptable to mothers when performed in hospital. What is New: • Pulse oximetry screening for critical congenital heart defects is also acceptable for mothers when the screening is performed at home.

Pulse Oximetry Screening Adapted to a System with Home Births: The Dutch Experience

“…We concluded that PO screening for CCHD, using the adapted protocol, was feasible in the Dutch perinatal care setting and that screening at home is acceptable to mothers [13,14].…”

“…We then assessed the acceptability of performing PO screening at home amongst 1172 mothers participating in the feasibility study by using questionnaire [14]. In this group, screening measurements were performed at least once at home by their community midwife.…”

Feasibility study assessing equitable delivery of newborn pulse oximetry screening in New Zealand’s midwifery-led maternity setting

“…The test is non-invasive, safe and easy to perform, and has been well-received by consumers. [1][2][3] Pulse oximetry screening has been introduced successfully into many healthcare settings around the world using approaches ranging from ad hoc implementation to mandatory policies. [4][5][6][7][8] New Zealand is an ethnically diverse country with a midwifery-led model of maternity care and policies that strive to deliver health services in a way that recognises the connexions between health and other aspects of people's lives, including culturally appropriate approaches to healthcare.…”

Pulse Oximetry Screening for Critical Congenital Heart Defects: A Life-Saving Test for All Newborn Babies

“…Giving appropriate information and assessing the acceptability of any screening test-both to the patients involved and to the clinical staff who administer it-is vital if it is to be successful. Previous studies have shown that POS is acceptable to parents and clinical staff [12,18,19] and also that it does not appear to create additional anxiety in the mothers (including those who have a false positive result) [18]. In this special edition, Cloete et al report feedback from parents on both the information they received prior to testing and their overall satisfaction of POS during a pilot screening study in New Zealand [20].…”

“…In addition, screening after 24 h of age may result in up to half of babies with CCHD presenting before POS occurs, sometimes with an acute deterioration [16,42]. These factors must be considered carefully; although a lower number of false positives is advantageous in a screening test, if the majority of false positives have a serious non-cardiac condition which requires urgent treatment, this is clearly a significant additional benefit [19]. In addition, later screening-after 24 hours-may lead to more babies with CCHD becoming seriously unwell before testing takes place, which defeats the purpose of screening [16,42].…”