Newborn screening (NBS), a comprehensive system that includes testing, diagnosis, follow-up, treatment, education, and evaluation, was recently named one of the Top 10 Great Public Health Achievements by the Centers for Disease Control and Prevention (CDC). 1 Each year, approximately 10,000 infants are identified with NBS conditions, which frequently go unnoticed at birth. 2 NBS is administered by state public health programs across the country and provides for early identification of newborns with certain congenital, metabolic, endocrine, hematologic, and other genetic conditions. Early identification of these conditions in newborns facilitates timely interventions that result in significant decreases in morbidity, mortality, and disability. 1 Screening begins by pricking a newborn's heel to get enough blood to fill a few circles on a filter paper card. The specimen, referred to as a dried blood spot, is collected by a health-care provider-typically at the birthing facilityduring the first 24-48 hours of life. Some states are required to collect two specimens, in which case the second specimen is collected between seven and 15 days of life. The specimens are then sent to a state-designated NBS laboratory for analysis. When a test result is out of normal range, laboratory or follow-up personnel contact the birthing facility and the newborn's physician to ensure the child receives the appropriate diagnostic work-up and treatment. NBS goes beyond blood-spot screening to include point-of-care testing for hearing and, in some states, critical congenital heart disease. These tests are performed at the hospital shortly after birth, and the state NBS program performs follow-up testing. Although there is some variability in protocols among states, most NBS programs have similar components, including specimen collection, laboratory testing, follow-up, education of providers and the public, verification of a diagnosis, treatment, and ongoing program evaluation. 3 Newborn Screening 15Public Health Reports / 2013 Supplement 2 / Volume 128
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