Minnesota Department of Health
2014
MEDICAL FACT SHEET
Blood Spot Screening for NICU Infants Weighing
Less than or Equal to 1800 Grams at Birth
When should specimens be collected from
infants weighing ≤1800 grams at birth?
What if the infant is discharged before a
repeat specimen is collected?
Specimens should be collected on the yellow
screening cards at 24-48 hours after birth, 14 days
of age, and 30 days of age.
If discharge is scheduled before the 14- or 30-day
mark, the newborn screening specimen should
be collected at discharge. The 14- and 30-day
specimens should not be collected from outpatients.
It is recommended that all three screens be
ordered upon the infant’s admission to the NICU.
It is important to remember to record the infant’s
birth weight on the screening card; not the infant’s
current weight.
Why should infants weighing ≤1800 grams
at birth be screened multiple times?
Infants weighing ≤1800 grams at birth should be
screened multiple times to minimize both false
positive and false negative results.
A neonate’s immaturity and the necessary
therapeutic interventions may combine to interfere
with both the collection of samples and the
interpretation of newborn screening results.
Viewing the results of multiple screens together will
give a more accurate picture of the neonate’s risk
for the disorders on Minnesota’s screening panel.
What if a transfusion is required?
If the infant requires any blood products before
24 hours of age, collect the initial specimen pretransfusion and the next specimen at 14 days of
age. A pre-transfusion specimen is essential for the
detection of some of the disorders on the newborn
screening panel.
If a specimen is not collected prior to the infant
receiving red blood cells, the screen must be
repeated 90 days after the last tranfusion. Results
from a specimen collected shortly after transfusion
are not valid for several disorders and may cause a
false negative result.
Does the laboratory screen these infants
differently?
No. The laboratory testing is the same and
clinicians will be notified of all abnormal results
as usual.
Are the newborn screening reports
different for these infants?
The report format is the same for all newborns,
but each report for an infant weighing ≤1800
grams at birth reminds the clinician to view all
three screens together.
The following situations are reported differently
for infants weighing ≤1800 grams at birth:
• If the initial screen for congenital adrenal
hyperplasia (CAH) is positive, the report will
suggest clinical evaluation of the infant and
a repeat screen at 14 days of age. Positive
results on repeat screens will be treated in
the same way as positive results in other
newborns.
• If the initial screen for severe combined
immune deficiency (SCID) is positive, the
report will direct clinicians to collect 14and 30-day specimens. An immunologic
evaluation should be considered only if the
clinical presentation is suggestive of SCID.
Where can I get additional information?
Newborn Screening Program:
(800) 664-7772
www.health.state.mn.us/newbornscreening
Newborn Screening Program, 601 Robert St. N., St. Paul, MN 55155, Phone (800) 664-7772, Fax (651) 215-6285