Document Detail


Effect of expanded newborn screening for biochemical genetic disorders on child outcomes and parental stress.
MedLine Citation:
PMID:  14625333     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
CONTEXT: Tandem mass spectrometry now allows newborn screening for more than 20 biochemical genetic disorders. Questions about the effectiveness and risks of expanded newborn screening for biochemical genetic disorders need to be answered prior to its widespread acceptance as a state-mandated program. OBJECTIVES: To compare newborn identification by expanded screening with clinical identification of biochemical genetic disorders and to assess the impact on families of a false-positive screening result compared with a normal result in the expanded newborn screening program. DESIGN: Prospective study involving an inception cohort of newly diagnosed children. SETTING: Massachusetts, Maine, and a private laboratory in Pennsylvania with expanded newborn screening; other New England states with limited screening. PARTICIPANTS: Families of 50 affected children identified through expanded newborn screening (82% of eligible cases); 33 affected children identified clinically (97% of eligible cases); 94 screened children with false-positive results (75% of eligible cases); and 81 screened children with normal results (63% of eligible cases). MAIN OUTCOME MEASURES: Child's health and development and the Parental Stress Index. RESULTS: Within the first 6 months of life, 28% of children identified by newborn screening compared with 55% of clinically identified children required hospitalization (P =.02). One child identified by newborn screening compared with 8 (42%) identified clinically performed in the range of mental retardation (P<.001). Mothers in the screened group reported lower overall stress on the Parental Stress Index than mothers in the clinically identified group (z = 3.38, P<.001). Children with false-positive results compared with children with normal results were twice as likely to experience hospitalization (21% [n = 20] vs 10% [n = 8], respectively; P =.06). Mothers of children in the false-positive group compared with mothers of children with normal screening results attained higher scores on the Parental Stress Index (z = 4.25, P<.001) and the Parent-Child Dysfunction subscale (z = 5.30, P<.001). CONCLUSIONS: Expanded newborn screening may lead to improved health outcomes for affected children and lower stress for their parents. However, false-positive screening results may place families at risk for increased stress and parent-child dysfunction.
Authors:
Susan E Waisbren; Simone Albers; Steve Amato; Mary Ampola; Thomas G Brewster; Laurie Demmer; Roger B Eaton; Robert Greenstein; Mark Korson; Cecilia Larson; Deborah Marsden; Michael Msall; Edwin W Naylor; Siegfried Pueschel; Margretta Seashore; Vivian E Shih; Harvey L Levy
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  JAMA : the journal of the American Medical Association     Volume:  290     ISSN:  1538-3598     ISO Abbreviation:  JAMA     Publication Date:  2003 Nov 
Date Detail:
Created Date:  2003-11-19     Completed Date:  2003-11-21     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  7501160     Medline TA:  JAMA     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2564-72     Citation Subset:  AIM; IM    
Affiliation:
Children's Hospital Boston, Mass 02115, USA. susan.waisbren@tch.harvard.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Attitude to Health
Child
Child Development*
Child, Preschool
Developmental Disabilities / diagnosis,  etiology
False Positive Reactions
Female
Health Status
Hospitalization / statistics & numerical data
Humans
Infant
Infant, Newborn
Male
Mass Spectrometry
Mental Retardation / diagnosis,  etiology
Metabolism, Inborn Errors / diagnosis*,  physiopathology,  therapy
Neonatal Screening* / psychology
Parents / psychology*
Prospective Studies
Stress, Psychological*
Grant Support
ID/Acronym/Agency:
5H46 MC 00158//PHS HHS; R01 HG02085/HG/NHGRI NIH HHS
Comments/Corrections
Comment In:
JAMA. 2003 Nov 19;290(19):2606-8   [PMID:  14625339 ]
JAMA. 2004 Mar 24;291(12):1444; author reply 1444-5   [PMID:  15039408 ]
J Pediatr. 2004 May;144(5):685-6   [PMID:  15151122 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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