Stopping Parenteral Nutrition for 3 Hours Reduces False Positives in Newborn Screening

Thipwimol Tim-Aroon; Heidi M Harmon; Mary L Nock; Sreekanth K Viswanathan; Shawn E McCandless

doi:10.1016/j.jpeds.2015.04.063

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Stopping Parenteral Nutrition for 3 Hours Reduces False Positives in Newborn Screening

Journal article

Peer reviewed

Stopping Parenteral Nutrition for 3 Hours Reduces False Positives in Newborn Screening

Thipwimol Tim-Aroon, Heidi M Harmon, Mary L Nock, Sreekanth K Viswanathan and Shawn E McCandless

The Journal of pediatrics, Vol.167(2), pp.312-316

08/2015

DOI: 10.1016/j.jpeds.2015.04.063

PMID: 26003996

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Abstract

To evaluate effects of holding parenteral nutrition (PN) for 3 hours prior to newborn screening (NBS) on false-positive NBS rate for amino acids (AAs) in very low birth weight (VLBW) infants (birth weight <1500 g). We analyzed data from 12 567 consecutive births in 1 hospital between May 2010 and June 2013. VLBW infants were stratified into 3 groups: (1) infants without PN before NBS (no-PN group); (2) infants with early PN running at the time of NBS (early-PN group); and (3) infants with early-PN that were temporarily replaced by dextrose-containing intravenous fluid 3 hours prior to NBS (stop-PN group). We compared the false-positive rate for AA and cost effectiveness between the groups. The false-positive rate for AA among 413 VLBW infants was significantly higher than infants with birth weight >1500 g (7.62% vs 0.05%; P < .001). There were no false-positive results for AA in the no-PN group. The false-positive rate for AA in the stop-PN group (2/65) was significantly lower than the early-PN group (29/245) (3.1% vs 11.8%; P = .037). The stop-PN group was more cost effective than early-PN group, saving $17.27 per infant screened ($5.53 vs $22.80) or $192.54 for each false-positive result for AA averted. Further reductions in inconclusive samples were also noted. VLBW and early-PN are significant factors for false-positive results for AA. Holding PN containing AAs for 3 hours before NBS collection is a practical and cost-effective method to significantly reduce the false-positive rate for AA in VLBW infants.

Predictive Value of Tests

Amino Acids - blood

Infant, Very Low Birth Weight

Humans

Infant

Male

Neonatal Screening - methods

False Positive Reactions

Time Factors

Parenteral Nutrition - methods

Infant, Premature

Sensitivity and Specificity

Female

Retrospective Studies

Infant, Newborn

Cohort Studies

Details

Title: Subtitle: Stopping Parenteral Nutrition for 3 Hours Reduces False Positives in Newborn Screening
Creators: Thipwimol Tim-Aroon - Center for Human Genetics, University Hospitals Case Medical Center, Cleveland, OH; Department of Genetics and Genome Sciences, Case Western Reserve University, Cleveland, OH
Heidi M Harmon - Division of Neonatology, Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, OH
Mary L Nock - Division of Neonatology, Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, OH
Sreekanth K Viswanathan - Division of Neonatology, Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, OH
Shawn E McCandless - Center for Human Genetics, University Hospitals Case Medical Center, Cleveland, OH; Department of Genetics and Genome Sciences, Case Western Reserve University, Cleveland, OH. Electronic address: Shawn.McCandless@uhhospitals.org
Resource Type: Journal article
Publication Details: The Journal of pediatrics, Vol.167(2), pp.312-316
DOI: 10.1016/j.jpeds.2015.04.063
PMID: 26003996
ISSN: 0022-3476
eISSN: 1097-6833
Language: English
Date published: 08/2015
Academic Unit: Stead Family Department of Pediatrics; Neonatology
Record Identifier: 9984093334802771

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