minnesota newborn screening program
Newborn Screening in the NICU
NICU staff are much more likely to deal with newborns who have abnormal newborn screening results. NICU providers will be involved in the follow-up of abnormal results, collection of repeat specimens, and assurance that all infants in their units have documented newborn screening results. While the disorders included in the newborn screening panel are individually rare, approximately 90 affected Minnesota babies are identified by newborn screening each year. Some of these babies may require intensive care for their disorders; others may be hospitalized for reasons not associated with one of the conditions on the screening panel; and some may have false positive or false negative results due to confounding factors such as immaturity, drug side-effects, or non-standard feeding needs.
Whether your primary role is as a neonatologist, neonatal nurse practitioner, nurse clinician, nurse, laboratory professional, or support staff member, you play an important role in newborn screening in the NICU.
Hearing Screening in the NICU
About 1-3:1,000 Minnesota babies are expected to have some level of congenital hearing loss. All infants born in Minnesota need to have their hearing screened before discharge. Because infants hospitalized in the NICU are at increased risk for hearing loss when compared with healthy term infants, it is vitally important that NICU babies have their hearing screened and the results of the screen reported to MDH.
Infants may be transferred from the NICU before hearing screening is completed. If a baby is sent either to a less acute hospital or to another inpatient setting, the receiving unit needs to be notified by NICU staff that hearing screening still needs to be completed. Hearing screening is the responsibility of the hospital staff that discharges baby to home. A form is available from MDH to send along with transferred infants regarding the need for hearing screening.
Hearing screening form for transferred infants (PDF 33KB/1 page)
The MN Hearing Advisory Committee has developed recommendations for newborn hearing screening in the NICU.
MN Early Hearing Detection and Intervention (EHDI) Program (PDF: 91KB/11 pages)
Are very premature infants screened differently?
Beginning in January 2006, the Newborn Screening Program undertook an initiative to improve the screening process for infants with birth weights under 1800 grams. Due to their immaturity, these small infants are more likely to have conditions that are missed by standard screening protocols. Prematurity, together with the therapeutic regimens that very low birth weight babies require, also make false positive results more likely. When a baby weighing less than 1800 grams is born, the Newborn Screening Program requests that specimens be collected at 14 and 30 days of age in addition to the initial newborn screen.
Reviewing the results of the three screens as the infant matures is likely to give a more complete picture of risk for the screened conditions. This reflexive rescreening protocol is likely to reduce both false positive and false negative results for NICU babies. All specimens from infants weighing less than 1800 grams at birth should be collected on a yellow newborn screening card.
For information on the NICU screening protocol:
NICU Fact Sheet (PDF: 77KB/1 page)