Congenital heart disease is one of several ailments, including pneumonia and sepsis, that kill eight babies every minute, every day. But a decades-old technology, combined with a smartphone app, can tell doctors in less than 60 seconds if a baby is at risk for any of these asymptomatic, hard-to-detect killers. And in developing nations like China, it costs less than a diaper change.

The program is called the BORN Project. It uses pulse oximetry technology to combat newborn mortality. You’ve seen (and have likely even used) a pulse oximeter: It’s that clip-on sensor with the little red beam of light that measures your blood oxygen levels at a yearly physical, or when you’re having outpatient surgery. You can even buy one at CVS or Walgreens. What the BORN Project does is advocate for congenital heart disease screening in newborns by using a pulse oximeter that sends vital data to a mobile app. The baby’s results are beamed anywhere there’s a cell signal, from front-line healthcare workers to doctors who can provide a follow-up.


This is crucial technology, especially for those newborns in low-resource, developing countries. Those oxygen levels can immediately tell doctors if something is wrong, because unusual levels are a really good indicator of problems like an asymptomatic heart defect in a baby.

BORN (which stands for Birth Oximetry Routine for Newborns) started when Newborn Foundation co-founder and CEO Annamarie Saarinen was facing a harsh reality herself. Her newborn daughter was discharged from the hospital like nothing was wrong, but two days later, she learned her new daughter suffers from a congenital heart defect. A couple of heart surgeries later, Saarinen, who has a health policy background, started researching and learned that one in every three newborns in the developed world were being discharged from nurseries where congenital heart defects were later reported. Meanwhile, one in 100 babies actually had such a defect. That’s when she decided to take action.

“What are we screening for?” Saarinen told me. “We screen for all these other things—the heel stick—we screen for conditions that are far more rare and far more difficult to treat, but we weren’t screening for heart defects.”


Previously, congenital heart disease screening was not required for newborns in America; now, thanks to Saarinen and her foundation, it is. In 2011, following state and federal testimony to support tech policy development in health care, Saarinen helped convince the U.S. Department of Health and Human Services to formally recommend that all American newborns be screened for congenital heart defects. Now, 96% of them are.


Implementing the technology BORN uses is key, since a recent study out of the U.K. revealed that 79% of all newborns who failed a pulse oximetry test had a serious, asymptomatic condition, from heart disease to pneumonia. And by the time the infant becomes symptomatic, the problem is much harder to treat.

The advocacy’s become a global initiative: After the project’s success in America, China reached out to Saarinen. “China contacted us and said, ‘We saw what you did in the U.S., could you help us do that in China?” Saarinen told me. “Their newborn mortality rate is in the top five in the world. So we worked with the government there on the provincial and national level to convene the first newborn screening summit in Beijing. Then we put together a pilot program in rural Sichuan province: We’re up and running in 50 hospitals, screening 78,000 newborns.”

They’re collecting data, so within the next six months they can bring it back to the Chinese government, who can then better care for the 17 million babies born each year in China.


In China, the BORN screening costs less than 50 cents. Here in the U.S., compared to other bundled newborn healthcare, it’s still cheap: Around five bucks. Compare that to the newborn hearing test, which costs $35 a baby. Next, the BORN Project wants to expand to more countries, like India and those in Latin America.

The BORN Project was one of 14 innovators chosen by the United Nations out of more than 800 entrants from across the world to help address the 17 Sustainable Development Goals. The BORN Project presented its mission alongside the other winners at UN Headquarters in New York last month.

A cheap, quick, and easy-to-use combo of both older and newer technologies, these mobile device pulse oximeters could give thousands of newborns a better chance of the long life they deserve.


CTO of the United States, Megan Smith (left), demonstrating the BORN screening system with Newborn Foundation co-founder and CEO Annamarie Saarinen at the Solutions Summit at UN Headquarters in New York in September. Credit: UN.

This story is part of a special series about the United Nations’ plans to solve global issues using emerging technology. Read more about it here.


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[Newborn Foundation]

Images via BORN Project