Background and objective: Preterm, low birth weight and sick newborns are at risk of missed or unreliable testing due to many factors such as infant condition, treatment, and maternal status. In June 2014, a newborn screening testing protocol which recommends performing the newborn screening test on babies less than 37 weeks age of gestation immediately after 24 h of birth and a second screening test at 28 days of age was implemented. This study is being undertaken to evaluate the impact, implications, and outcomes of the new testing protocol in the screening of preterm babies.
Methods: This is a descriptive study which includes one year screening data (June 2014-May 2015) of babies less than 37 weeks of age at the Newborn Screening Center, National Institutes of Health (NSC-NIH), Manila. Data extracted include laboratory number, date of birth, date of collection, age at collection, birth weight, age of gestation, initial result, date of repeat collection, age at repeat collection, repeat test result, and confirmatory tests results. The completed data will be analyzed further under the 2 age groups, namely, the <35 weeks age group and the 35 weeks to <37 weeks age group.
Results: Preliminary data show that there were 11,297 babies less than 37 weeks age of gestation who had newborn screening at the NSC-NIH, 10,089 of them had normal results on initial screen. Of the 10,089 babies who had normal initial screening result, only 180 babies had repeat testing at 28 days of age and beyond as of May 22,2015. Of these 180 babies, 2 turned out to be positive for congenital hypothyroidism and were confirmed through thyroid function testing, and 3 turned out to be positive for glucose-6-phosphate dehydrogenase (G6PD) deficiency.
Conclusions: Uptake of the protocol on its first year of implementation is still very low. Nevertheless, even with this low availment for repeat tests at 28 days of age, 5 out of 10,089 babies who initially had normal screening results had repeat testing which turned out to be positive and confirmed for either congenital hypothyroidism or G6PD deficiency. The results of this study could be used as basis to justify the need for additional testing at 28 days of age in preterm babies. Further analysis under different age groups will help in the determination of appropriate age of gestation cut-offs for the current protocol.
