Coverage of the Victorian newborn screening programme in 2003: a retrospective population study.
OBJECTIVE
To assess the coverage of the newborn screening (NBS) program in Victoria, Australia, and identify potential predictors of not being screened.


METHODS
Victoria, Australia, 2003. The Victorian NBS program screens for phenylketonuria (PKU), cystic fibrosis, congenital hypothyroidism and more than 20 metabolic conditions, such as medium chain acyl-coenzyme A dehydrogenase (MCAD) deficiency.


METHODS
Victorian birth records (n = 63,018) were linked to Victorian NBS records (n = 62,876) using probabilistic record linkage. Binary logistic regression was used to identify potential predictors of not being screened.


RESULTS
Uptake of NBS was 99.4% (62,643/63,018), resulting in 0.6% (375) of livebirths not matched to a NBS test. Neonatal death was the most significant factor associated with not being screened (relative risk (RR) = 407, 95%Cl = 314 to 526). After adjustment, surviving livebirths had an increased likelihood of not being matched to a NBS record if they: were transferred between hospitals (odds ratio (OR) = 2.4, 95% confidence interval (Cl) 1.5 to 3.9); were born at home (OR = 12.1, 95%Cl 6.3 to 23.3); resided in rural Victoria (OR = 2.6, 95%Cl 1.5 to 4.3); stayed in hospital for one day or less (OR = 4.6, 95%Cl 2.8 to 7.6); or whose mothers were primiparous (OR = 1.5, 95%Cl 1.1 to 2.1).


CONCLUSIONS
NBS uptake is extremely high in Victoria with over 99% of livebirths screened. Particular risk factors for not having NBS have now been identified, which could lead to changes around monitoring neonates who are not born in a hospital, or leave/transfer hospital, before the NBS period (48-72 hours). Future studies could determine whether those not screened had opted-out or were not offered NBS.
Jaques
Alice M
AM
Public Health Genetics, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia. alice.jaques@mcri.edu.au
Collins
Veronica R
VR
Pitt
James
J
Halliday
Jane L
JL
D001719:Birth Certificates; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008498:Medical Record Linkage; D015997:Neonatal Screening / Q000458:organization & administration / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014739:Victoria