Child Health Evaluation and Research Unit, University of Michigan, Ann Arbor, Michigan 48109-0456, USA.
Pediatrics. 2011 Oct;128(4):715-22. doi: 10.1542/peds.2010-2448. Epub 2011 Sep 19.
To compare health care visit rates between infants with false-positive and those with normal newborn screening (NBS) results.
We analyzed administrative claims of Medicaid-enrolled infants born in Michigan in 2006 and calculated the average number of outpatient, emergency department, and hospital visits for infants aged 3 to 12 months according to NBS results. We calculated an adjusted incidence rate ratio for each visit category, adjusting for covariates and accounting for interaction effects.
Of the 49,959 infants in the analysis, 818 had a false-positive NBS result. We noted a significant interaction between gestational age and NBS results. We found that preterm, but not term, infants with false-positive results had more acute outpatient visits than their counterparts with normal NBS results. We found no difference in adjusted rates of other visit types (emergency department, inpatient, outpatient well) between infants with false-positive and normal NBS results, regardless of gestational age.
Increased rates of acute outpatient visits among preterm infants with false-positive NBS screening results may be attributable to underlying chronic illness or parental anxiety. The absence of increased health care utilization among term infants may be unique to this Medicaid population or a subgroup phenomenon that was not detectable in this analysis.
比较假阳性和正常新生儿筛查（NBS）结果婴儿的医疗保健就诊率。
我们分析了 2006 年在密歇根州出生的参加医疗补助计划的婴儿的行政索赔，并根据 NBS 结果计算了 3 至 12 个月大婴儿的门诊、急诊和住院就诊的平均次数。我们为每个就诊类别计算了调整后的发病率比值，调整了协变量并考虑了交互作用。
在分析的 49959 名婴儿中，有 818 名婴儿的 NBS 结果为假阳性。我们注意到胎龄和 NBS 结果之间存在显著的交互作用。我们发现，与正常 NBS 结果相比，假阳性结果的早产儿而非足月儿有更多的急性门诊就诊。无论胎龄如何，我们都没有发现假阳性和正常 NBS 结果婴儿之间其他就诊类型（急诊、住院、门诊）的调整后就诊率存在差异。
假阳性 NBS 筛查结果的早产儿急性门诊就诊率增加可能归因于潜在的慢性疾病或父母的焦虑。足月婴儿的医疗保健利用率没有增加，这可能是该医疗补助人群所特有的，或者是本分析中无法检测到的亚组现象。
