医学
儿科
新生儿筛查
先天性甲状腺功能减退
妊娠期
采样(信号处理)
血液取样
回顾性队列研究
怀孕
外科
内科学
甲状腺
滤波器(信号处理)
生物
计算机科学
计算机视觉
遗传学
作者
Emese Boros,Lionel Marcélis,Guy Van Vliet,Farel Elilie Mawa Ongoth,Claudine Heinrichs,Cécile Brachet
出处
期刊:Thyroid
[Mary Ann Liebert]
日期:2023-11-01
卷期号:33 (11): 1311-1317
标识
DOI:10.1089/thy.2023.0114
摘要
Objective: Until November 2019 in Belgium, dried blood spot (DBS) sampling was performed between 72 and 120 hours of life, when a majority of newborns had already been discharged from the maternity. In November 2019, the policy for newborn screening in South Belgium changed to allow sampling as soon as 48 hours of life, with the objective to accelerate the process and to allow more sampling during the hospital stay. Our objective was to evaluate the impact of this policy modification and, in particular, to assess the effectiveness of screening for hypothyroidism based on sampling before or after 72 hours of life, as well as to compare the effectiveness of DBS collection before discharge or at home. Methods: This retrospective study included live births ≥37 weeks of gestation, screened by the Université Libre de Bruxelles Newborn Screening Center between January 2019 and December 2021. To evaluate the efficiency of early sampling, we compared thyrotropin (TSH) results for screening <72 hours and screening ≥72 hours. We also compared TSH results of DBS performed before discharge with those performed at home. Results: A total of 53,794 newborns were included. The results of 24,816 healthy newborns screened before 72 hours of life and of 28,978 healthy newborns screened between 72 and 144 hours of life were compared. The median TSH level was similar (1.50 and 1.20 mU/L, respectively). The percentage of false positives was similar (0.08% and 0.07%, respectively). Earlier sampling, before 72 hours, allowed treatment of positive cases at 6 days rather than 8.5 days. DBS sampling at home resulted in longer delay for transferring the sample to the laboratory (a median of 3.0 days for hospital sampling vs. 5.0 days for home sampling). A poorer quality of home blood sampling was observed, with 0.27% unusable samples compared with 0.06% unusable samples for hospital sampling (p < 0.001). Conclusions: In term newborns, TSH screening before discharge, as early as 48 hours of life, is a valid strategy. It allows earlier treatment of positive cases, does not increase the percentage of false positives, and results in fewer unusable samples.
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