Skip to main content
Open Access Publications from the University of California

UC Davis

UC Davis Previously Published Works bannerUC Davis

Lower pass threshold (≥93%) for critical congenital heart disease screening at high altitude prevents repeat screening and reduces false positives.



We evaluated first screen pass rate for two pass thresholds for critical congenital heart disease (CCHD) oxygen saturation (SpO2) screening at higher altitude.

Study design

A retrospective cohort of 948 newborns underwent CCHD screening near sea-level (n = 463) vs 6250 ft altitude (n = 485) over 3 years. Standard SpO2 pass threshold ≥95% and lower SpO2 pass threshold ≥93% (high-altitude screen) were applied to first measurements to compare pass frequencies.


The median SpO2 was lower in high-altitude newborns (96% vs 99%-p < 0.001). The high-altitude newborns passed the AAP algorithm first screen less often (89.3% vs 99.6%-p < 0.001). With the high-altitude algorithm, 98% of high-altitude newborns passed the first screen.


Lowering the SpO2 pass threshold by 2% at >6000 ft, significantly increased first screen pass rate. Adjustments for altitude may reduce nursing time to conduct repeat measurements and prevent transfers for echocardiograms. Larger studies are necessary to assess impact on false negatives.

Many UC-authored scholarly publications are freely available on this site because of the UC's open access policies. Let us know how this access is important for you.

Main Content
For improved accessibility of PDF content, download the file to your device.
Current View