Managing Newborn Screening Repeat Collections for Sick and Preterm Neonates.

IF 4 Q1 GENETICS & HEREDITY International Journal of Neonatal Screening Pub Date : 2024-09-16 DOI:10.3390/ijns10030063
Ronda F Greaves, Jo-Ann Northfield, Lauren Cross, Nazha Mawad, Thanh Nguyen, Maggie Tan, Michele A O'Connell, James Pitt
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Abstract

Some preterm and sick neonates have altered biochemical profiles and follow-up newborn screening (NBS) collections are recommended. The Victorian NBS program historically recommended repeat collections for babies with birth weight < 1500 g (managed by the maternity service provider) and 3 weeks post-transfusion (managed by the laboratory). We aimed to determine adherence to current guidelines and review the guidelines to improve NBS performance. To do this, we audited data from 348,584 babies between January 2018 and June 2022. Babies with a recorded birth weight of <1500 g were filtered for inclusion. For the overall review and visualization of the protocol, we sourced information from the literature, our professional society and tertiary hospital services. A total of 2647 babies had a birth weight recorded between 200 and 1499 g. Of these, 2036 (77%) had a second sample collected, indicating that >1 in 5 babies were not receiving a follow-up collection. Our timing of repeat collections for transfused babies, requiring a 3-week follow-up collection, was longer than in other Australasian jurisdictions. A new combined "sick-prem protocol" was launched to support repeat collections and after a 1-year review achieved 95% compliance. We recommend NBS laboratories audit preterm and sick neonate repeat collections to ensure appropriate follow-up. This should be supported with a visual process map to aid education and compliance.

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管理患病和早产新生儿的新生儿筛查重复采集。
一些早产儿和患病新生儿的生化指标会发生变化,因此建议进行后续的新生儿筛查 (NBS) 采集。维多利亚州的新生儿筛查计划历来建议对出生体重小于 1500 克(由产科服务提供商管理)和输血后 3 周(由实验室管理)的婴儿进行重复采集。我们的目标是确定现行指南的遵守情况,并对指南进行审查,以提高 NBS 的绩效。为此,我们审核了 2018 年 1 月至 2022 年 6 月期间 348584 名婴儿的数据。记录出生体重的婴儿中有五分之一未接受后续采集。与澳大拉西亚其他辖区相比,我们对输血婴儿的重复采集时间(需要 3 周的后续采集)更长。为支持重复采集工作,我们推出了一项新的 "病前-病后 "联合协议,经过 1 年的审查,该协议的合规率达到了 95%。我们建议 NBS 实验室对早产儿和患病新生儿的重复采集进行审核,以确保适当的随访。这项工作应辅之以可视化流程图,以帮助开展教育和提高依从性。
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来源期刊
International Journal of Neonatal Screening
International Journal of Neonatal Screening Medicine-Pediatrics, Perinatology and Child Health
CiteScore
6.70
自引率
20.00%
发文量
56
审稿时长
11 weeks
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