Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #117479

Kimberly Kimiko Cobb, MS, RD, LDN, Maternal and Child Health, The University of North Carolina at Chapel Hill, 2701 Homestead Road, Unit 804, Chapel Hill, NC 27516, 919-968-1615, kkcobb@email.unc.edu

The NC Newborn Screening Program began expanded metabolic (amino acid/acylcarnitine (AA/AC)) screening using Tandem Mass Spectrometry in 1997. The protocol for result classification uses a two tiered system of cut-offs. AA/AC results that exceed upper (diagnostic) cut-off for an analyte prompt immediate contact with the primary care physician (PCP), location of the newborn and referral to a metabolic center for confirmatory testing. Results exceeding the lower (borderline) cut-off generate a report to the PCP and birthing hospital with instructions to collect a repeat screen (RS). This study looks at the success of compliance for submission of RS on infants with initial borderline results during 2000-2003. NBS demographic data were linked to birth certificates and 2000 US Census data to provide additional variables. A RS was not received for 8% of these “borderline” infants. Although there were no known false positives in this group, they represent a population at risk for having a metabolic disorder. Using logistic regression analysis adjusted for clustering, Black (OR 2.1, CI 1.3, 3.3) and Hispanic infants (OR 2.2, CI 1.2, 4.0) were less likely to have submitted a RS than Caucasian infants. Infants from communities with low socioeconomic index (OR 2.3, CI 1.4, 3.9), from greater than 25 miles from their PCP (OR 1.6, CI 1.1, 2.3), and whose parental notification letter was undeliverable (OR 1.6, CI 1.1, 2.3) were also less likely to have a RS. Strategies that address the follow-up of these infants could further improve the efficiency of collection and submission of RS.

Learning Objectives:

• Discuss the role of metabolic newborn screening as a public health program to reduce morbidity and morality.
• Determine factors that are associated with lack of indicated repeat metabolic newborn screening.
• List specific policy recommendations that can improve the effectiveness of metabolic newborn screening.

Keywords: Neonatal Screening,

Presenting author's disclosure statement:

Not Answered