Diabetes & Other Endocrine and Metabolic Disorders
Newborn Screening Tests
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What are newborn screening tests?
Nearly all babies will have a simple blood test to check for disorders that are not apparent immediately after delivery. Some of these disorders are genetic, metabolic, blood, or hormone-related. Each state in the United States requires screening tests, but the specific tests performed vary among the states. Some disorders are more common in some states, making testing more important.
A heel-prick is used to sample the baby's blood. The blood drops are collected in a small vial or on a special paper. The blood is then sent for testing. The baby's heel may have some redness at the pricked site, and some babies may have bruising, but this usually disappears in a few days.
Newborn screening tests may include:
- phenylketonuria (PKU)
PKU is an inherited disease in which the body cannot metabolize a protein called phenylalanine. It is estimated that one baby in 10,000 to 25,000 is born with PKU in the United States. Without treatment, PKU can cause mental retardation. Newborn screening for PKU is required in all 50 states.
- congenital hypothyroidism
This is a condition in which the baby is born with too little thyroid hormone. Hypothyroidism is also quite common, occurring in about one in every 6,000 to 7,000 births in the United States. Untreated low thyroid hormone levels can lead to mental developmental problems and poor growth. All 50 states screen for hypothyroidism.
- galactosemia
This is an inherited disorder in which the baby is unable to metabolize galactose, a milk sugar. It occurs in about one baby in every 50,000. Without treatment (avoidance of milk), galactosemia can be life threatening. Symptoms may begin in the first two weeks of life. Nearly all states screen for galactosemia.
- sickle cell disease
This inherited disorder occurs primarily in African-Americans, but may also occur in Hispanics and Native Americans. The disease causes a severe form of anemia. There are different types of the disease. The incidence ranges from one in 400 to one in 1,400, depending on the type of disease. Early diagnosis of sickle cell disease can help lower some of the risks which include severe infections, blood clots, and stroke.
- maple syrup urine disease
This is an inherited disorder that affects one in 250,000 births. The disease is very common in the Mennonite population - as many as one in 760. The disorder is caused by an inability of the body to properly process certain parts of protein called amino acids. The name comes from the characteristic odor of maple syrup in the baby's urine caused by the abnormal protein metabolism. If untreated, it is life threatening as early as the first 2 weeks of life. Even with treatment, severe disability and paralysis can occur.
- homocystinuria
This inherited disorder affects one in 250,000 babies and causes mental retardation, bone disease, and blood clots. It is caused by a deficiency of an enzyme necessary to digest an amino acid called methionine.
- biotinidase deficiency
This inherited disorder is characterized by a deficiency of the biotinidase enzyme. This enzyme is important in metabolizing biotin, a B vitamin. It affects one in 70,000 babies in the United States and is most common in the Caucasian population. Lack of the enzyme can lead to severe acid build up in the blood, organs, and body systems.
- congenital adrenal hyperplasia
Most states screen for this inherited disease of the adrenal glands. Babies born with congenital adrenal hyperplasia (CAH) cannot make enough of the hormone cortisol, which helps control energy, sugar levels, blood pressure, and how the body responds to the stress of injury or illness. The Endocrine Society estimates the incidence of CAH at about one in 1,000 to one in 15,000, depending on the serverity of the disease. CAH may also affect the development of the genitals and the hormones of puberty.
Other tests screen for disorders including congenital toxoplasmosis, cystic fibrosis, and a disorder of fatty acid oxidation called MCAD. Some states are using a new testing technique called tandem mass spectrometry (MS/MS) which can detect more than 30 disorders using a simple blood sample, including those involving protein and fatty acid metabolism.
Most screenings cannot be performed until a baby has received at least 24 hours of breast milk or formula. Your baby may need follow-up testing if you are discharged before this time or the baby is unable to be tested before discharge.
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Contact Information
Jennifer Amaral
Endocrinology and DiabetesStephen W. Ponder, M.D. C.D.E. - Medical Director
Endocrinology and DiabetesChildren's Diabetes and Endocrine Center
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3533 S. Alameda St.
Corpus Christi, TX 78411
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