Neonatal biochemical screening for disease.
BACKGROUND
The practice of screening the neonatal population for certain diseases by biochemical testing of a dried blood spot is an established public health initiative in many countries. The diseases for which screening is done vary from region to region, based on ethnic, financial and political considerations. Criteria have been established to identify diseases suitable for neonatal screening.
In Western countries, screening for phenylketonuria (PKU) and congenital hypothyroidism (CH) has been introduced throughout. Subsequently, cost-benefit analysis has confirmed the existence of a financial benefit. Other diseases screened for in some regions include galactosemia, aminoacidemias and organic acidemias, cystic fibrosis, congenital adrenal hyperplasia, biotinidase deficiency, hemoglobinopathies, glucose-6-phosphate dehydrogenase deficiency, and Duchenne muscular dystrophy, although in no case has a clear financial benefit been established.


CONCLUSIONS
Since the introduction of neonatal screening over 40 years ago, new methods have resulted in an increase in the number of diseases amenable to screening, better automation and greater specificity. Methods currently used include growth of an inhibited bacterial auxotroph (the original phenylalanine (phe) method of Dr. Robert Guthrie), spectrophotometry, fluorometry, immunoassay, and tandem mass spectrometry with electrospray ionization.
Clague
Alan
A
Queensland Health Pathology Service, Neonatal Screening Laboratory, Pathology Department, Royal Brisbane Hospital Campus, Herston Road, Herston, Queensland 4029, Australia.
Thomas
Andrew
A
D000312:Adrenal Hyperplasia, Congenital / Q000175:diagnosis; D003409:Congenital Hypothyroidism; D003362:Cost-Benefit Analysis; D003550:Cystic Fibrosis / Q000175:diagnosis; D004992:Ethics, Medical; D005693:Galactosemias / Q000175:diagnosis; D006453:Hemoglobinopathies / Q000175:diagnosis; D006801:Humans; D007037:Hypothyroidism / Q000097:blood / Q000175:diagnosis*; D007231:Infant, Newborn; D008607:Intellectual Disability / Q000517:prevention & control; D015997:Neonatal Screening / Q000191:economics; D010661:Phenylketonurias / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011788:Quality of Life; D012680:Sensitivity and Specificity