Wall Terry C, Brumfield Cynthia G, Cliver Suzanne P, Hou Jinrong, Ashworth Carolyn S, Norris M Jean
Department of Pediatrics, Division of General Pediatrics, University of Alabama at Birmingham, 1616 6th Avenue South, Suite 201, Birmingham, AL 35233, USA.
J Pediatr. 2003 Aug;143(2):213-8. doi: 10.1067/S0022-3476(03)00247-6.
To examine the impact of early discharge on newborn metabolic screening.
Metabolic screening results were obtained from the Alabama State Lab for all infants born at our hospital between 8/1/97, and 1/31/99, and were matched with an existing database of early discharge infants. An early newborn discharge was defined as a discharge between 24 and 47 hours of age. Metabolic screening tests included phenylketonuria (PKU), hypothyroidism, and congenital adrenal hyperplasia (CAH). Early discharge and traditional stay infants were compared to determine the percentage of newborns screened and the timing of the first adequate specimen.
The state laboratory received specimens from 3860 infants; 1324 were on early discharge newborns and 2536 infants in the traditional stay group. At least one filter paper test (PKU, hypothyroidism, and CAH) was collected on 99.2% of early discharge infants and 96.0% of traditional stay infants (P<.0001). Early discharge infants had a higher rate of initial filter paper specimens being inadequate (22.9%) compared with traditional stay infants (14.3%, P<.0001) but had a higher rate of repeat specimens when the initial specimen was inadequate (85.0% early discharge vs 75.3% traditional stay, P=.002). The early discharge group was more likely to have an adequate specimen within the first 9 days of life (1001, 98.8% early discharge vs 2016, 96.7% traditional stay, P=.0005).
In this well established early discharge program with nurse home visits, newborn metabolic screening is not compromised by early discharge.
探讨早期出院对新生儿代谢筛查的影响。
获取了阿拉巴马州实验室对1997年8月1日至1999年1月31日在我院出生的所有婴儿的代谢筛查结果，并将其与现有的早期出院婴儿数据库进行匹配。早期新生儿出院定义为出生后24至47小时内出院。代谢筛查测试包括苯丙酮尿症（PKU）、甲状腺功能减退症和先天性肾上腺皮质增生症（CAH）。比较早期出院婴儿和传统住院婴儿，以确定进行筛查的新生儿百分比以及首次获取足够样本的时间。
州实验室收到了3860名婴儿的样本；其中1324名是早期出院的新生儿，2536名婴儿属于传统住院组。99.2%的早期出院婴儿和96.0%的传统住院婴儿至少进行了一次滤纸测试（PKU、甲状腺功能减退症和CAH）（P<0.0001）。与传统住院婴儿（14.3%）相比，早期出院婴儿初始滤纸样本不合格的比例更高（22.9%，P<0.0001），但当初始样本不合格时，早期出院婴儿重复采样的比例更高（早期出院组为85.0%，传统住院组为75.3%，P = 0.002）。早期出院组在出生后9天内更有可能获得足够的样本（1001例，早期出院组为98.8%，传统住院组为2016例，96.7%，P = 0.0005）。
在这个已成熟的有护士家访的早期出院项目中，新生儿代谢筛查不会因早期出院而受到影响。
