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A high rate of false positive newborn screening results in the neonatal intensive care unit

Asghar A, Shabanova V, Mercurio MR, Bizzarro MJ

Introduction: Newborn screen false positive rates are increased in the preterm infant, low birth weight and very low birth weight infant. The factors contributing to this high false positive rate have not been fully elucidated.

Objective: Determine rate of false positive (FP) newborn screening (NBS) tests in the Yale-New Haven Children’s Hospital neonatal intensive care unit (NICU) and assess the effectiveness of an intervention to decrease this rate.

Methods: Pre-post intervention study of 1,451 admissions to the NICU in 2012 (Period 1) and March 31, 2013 to March 30, 2014 (Period 2). FP rates were assessed in Period 1. Modified NBS collection guidelines were then implemented to withhold total parenteral nutrition 4 hours prior to obtaining sample. Period 2 data were compared to Period 1 using binomial logistic regression.

Results: 77% of all extremely low birth weight (ELBW) infants and 52% of all infants 1000-1499 g BW had at least one FP NBS result in Period 1. There was a trend towards reduction in the rates of FP results in Period 2.

Conclusion: Despite withholding TPN for 4 hours, the high rate of FP NBS results in our NICU did not significantly change.