Lavin Lindsay Roofe, Higby Nicholas, Abramo Thomas
*Pediatric Emergency Medicine Fellow (Lavin) and Assistant Professor of Pediatrics (Higby), Division of Pediatric Emergency Medicine, Department of General Pediatrics, Vanderbilt University, Nashville, TN; and †Professor of Pediatrics and EM Section Chief (Abramo), Pediatric Emergency Medicine, University of Arkansas for Medical Sciences, Arkansas Children's Hospital, Little Rock, AR.
Pediatr Emerg Care. 2015 Sep;31(9):661-7; quiz 667-9. doi: 10.1097/PEC.0000000000000549.
Newborn screening programs were established in the United States in the early 1960s. Newborn screening programs were then developed by states and have continued to be the responsibility of the state. All states require a newborn screening, but what is required of these programs and screening panels has differed greatly by state. Historically, the most commonly screened disorders are the following: congenital hypothyroidism, congenital adrenal hyperplasia, sickle cell disease and associated hemoglobinopathies, biotinidase deficiency, galactosemia, cystic fibrosis and phenylketonuria, maple syrup urine disease, and homocystinuria. However, under new guidelines in 2006 and with new advances in technology, the scope of newborn screening programs has expanded to include at a minimum 9 organic acidurias, 5 fatty acid oxidation disorders, 3 hemoglobinopathies, and 6 other conditions. This CME article reviews the logistics of newborn screening and explores the effect of new technology and recent policy on state screens and what that means for providers. This article also highlights several of the disorders most relevant to emergency room physicians and discusses future considerations of newborn screening.
新生儿筛查项目于20世纪60年代初在美国设立。随后,各州开展了新生儿筛查项目,并且该项目一直由各州负责。所有州都要求进行新生儿筛查,但各州对这些项目及筛查组合的要求差异很大。从历史上看,最常筛查的疾病如下:先天性甲状腺功能减退症、先天性肾上腺皮质增生症、镰状细胞病及相关血红蛋白病、生物素酶缺乏症、半乳糖血症、囊性纤维化和苯丙酮尿症、枫糖尿症和同型胱氨酸尿症。然而,根据2006年的新指南以及技术的新进展,新生儿筛查项目的范围已扩大,至少包括9种有机酸尿症、5种脂肪酸氧化障碍、3种血红蛋白病和6种其他病症。这篇继续医学教育文章回顾了新生儿筛查的相关事宜,探讨了新技术和近期政策对各州筛查的影响以及这对医疗服务提供者意味着什么。本文还重点介绍了一些与急诊医生最相关的疾病,并讨论了新生儿筛查未来的考量因素。