pediatrics
Screening Tests for Newborns
Introduction
Screening recommendations for newborns vary by clinical context and regulatory requirements. In the United States, the Health Resources & Services Administration recommends screening for all disorders included in theRecommended Uniform Screening Panel. Blood typing is indicated when the mother has type O or Rh-negative blood or when minor blood antigens are present, because Hemolytic Disease of the Fetus and Neonate is a risk. All neonates are evaluated for jaundice throughout the hospital stay and before Hospital Discharge of the Newborn . The risk of Many government organizations require testing for specific Introduction to Inherited Disorders of Metabolism , including HIV screening is required by some government organizations and is indicated for children of mothers known to be HIV-positive or those engaging in HIV high-risk behaviors. Toxicology screening is indicated when any of the following are present: Drug Safety in Pregnancy , unexplained Screening for critical congenital heart disease (CCHD)using pulse oximetry is part of routine newborn assessment. Previously, newborns were screened for CCHD by prenatal ultrasonography and by physical examination, but this approach failed to identify many cases of CCHD, which led to increased morbidity and mortality. The screening is done when infants are ≥ 24 hours old and is considered positive if Any oxygen saturation measurement is < 90%. The oxygen saturation measurements in both the right hand and foot are < 95% on 3 separate measurements taken 1 hour apart. There is > 3% absolute difference between the oxygen saturation in the right hand (preductal) and foot (postductal) on 3 separate measurements taken 1 hour apart. Any infant with a positive screen should have additional testing, including chest x-ray, electrocardiography, and echocardiography. The infant’s pediatrician should be notified, and the infant may need to be evaluated by a cardiologist. varies by state. Hearing Impairment in Children is one of the most frequently occurring birth defects. About 2 to 3/1000 infants are born with moderate, profound, or severe hearing loss ( Factor Factor Specifics Specifics Birth weight <1500 g Apgar score ≤7 at 5 minutes Serum bilirubin >22 mg/dL (>376 micromol/L) in neonate whose birth weight is>2000 g >17 mg/dL (>290 micromol/L) in neonate whose birth weight is<2000 g Disorders Perinatal anoxia or hypoxia Neonatal Sepsis or Introduction to Congenital Craniofacial and Musculoskeletal Abnormalities None Neonatal Seizure Disorders or apneic spells Congenital infections Rubella None Congenital Syphilis None Neonatal Herpes Simplex Virus (HSV) Infection None Congenital and Perinatal Cytomegalovirus Infection (CMV) None Congenital Toxoplasmosis None Maternal medications Aminoglycosides Family history Early hearing loss in a parent or close relative 