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American Public Health Association
133rd Annual Meeting & Exposition
December 10-14, 2005
Philadelphia, PA
APHA 2005
4274.0: Tuesday, December 13, 2005 - Board 5

Abstract #117479

Evaluation of follow-up in metabolic newborn screening in North Carolina

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

North Carolina was one of the first states to expand metabolic newborn screening (NBS) to screen for over 25 disorders. However, the NBS Program has not evaluated how well they follow-up infants with abnormal screens to receive an indicated repeat screen. Ensuring that infants are not lost to follow-up is important to prevent or reduce morbidity and mortality associated with delayed treatment. This study includes all infants born in NC during 2000-2003 who had abnormal metabolic NBS results (n=2328 of ~130,000 screened annually). Data from NBS Records were linked with Birth Certificate and Census data. Approximately, 11% of infants failed to have a repeat screen. Of all infants with abnormal screens, 8% of families failed to receive the repeat request letter, 25% of whom failed to have a repeat screen. A bivariate analysis found that risk of not having a repeat screen increased the further infants lived from their health care provider. Similarly, Hispanic infants (OR 2.1, CI (1.53, 3.06)) and African-American infants (OR 1.9, CI (1.38, 2.63)) were more likely to not have a repeat screen. This study further examines the frequency and trends of loss to follow-up for repeat NBS associated with individual-level factors (race/ethnicity, parental age and education level, parity, letter response and infant-provider distance) and community-level factors (economic deprivation index and physician density). Results from this study will be used to recommend policy changes and improve effectiveness and efficiency of the NBS Program through consistent and timely follow-up of infant.

Learning Objectives:

Keywords: Neonatal Screening,

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Infant and Child Health: Policy and Practice

The 133rd Annual Meeting & Exposition (December 10-14, 2005) of APHA