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Author Notes:

Cora Peterson, PhD, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, MS E-86, Atlanta, GA 30333. cora.peterson@cdc.hhs.gov

Dr Peterson led the study design, data analysis, and interpretation of findings; and drafted the initial manuscript. Dr Grosse assisted with the study design, data analysis, and interpretation of findings; and edited the manuscript. Drs Oster and Olney provided clinical oversight, assisted with the interpretation of findings, and edited the manuscript. Dr Cassell assisted with the study design and interpretation of findings, and edited the manuscript. All authors approved the final manuscript as submitted.

The authors have no financial relationships relevant to this article to disclose.


Research Funding:

No external funding.


  • Science & Technology
  • Life Sciences & Biomedicine
  • Pediatrics
  • congenital heart defects
  • neonatal screening
  • costs and cost analysis

Cost-Effectiveness of Routine Screening for Critical Congenital Heart Disease in US Newborns


Journal Title:



Volume 132, Number 3


, Pages E595-E603

Type of Work:

Article | Post-print: After Peer Review


OBJECTIVES: Clinical evidence indicates newborn critical congenital heart disease (CCHD) screening through pulse oximetry is lifesaving. In 2011, CCHD was added to the US Recommended Uniform Screening Panel for newborns. Several states have implemented or are considering screening mandates. This study aimed to estimate the costeffectiveness of routine screening among US newborns unsuspected of having CCHD. METHODS: We developed a cohort model with a time horizon of infancy to estimate the inpatient medical costs and health benefits of CCHD screening. Model inputs were derived from new estimates of hospital screening costs and inpatient care for infants with late-detected CCHD, defined as no diagnosis at the birth hospital. We estimated the number of newborns with CCHD detected at birth hospitals and life-years saved with routine screening compared with no screening. RESULTS: Screening was estimated to incur an additional cost of $6.28 per newborn, with incremental costs of $20 862 per newborn with CCHD detected at birth hospitals and $40 385 per life-year gained (2011 US dollars). We estimated 1189 more newborns with CCHD would be identified at birth hospitals and 20 infant deaths averted annually with screening. Another 1975 false-positive results not associated with CCHD were estimated to occur, although these results had a minimal impact on total estimated costs. CONCLUSIONS: This study provides the first US cost-effectiveness analysis of CCHD screening in the United States could be reasonably cost-effective. We anticipate data from states that have recently approved or initiated CCHD screening will become available over the next few years to refine these projections.

Copyright information:

© 2013 by the American Academy of Pediatrics.

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