[Back-of-the hand venepuncture. An alternative to heel puncture?]

Area of Science:

• Neonatal Medicine
• Pediatric Endocrinology

Background:

• Heel puncture for newborn metabolic screening (hypothyroidism, phenylketonuria) is painful.
• Venepuncture presents a potential less painful alternative.

Purpose of the Study:

• Compare pain and efficiency of venepuncture versus heel puncture in newborns.
• Evaluate false positive rates for hypothyroidism screening between methods.

Main Methods:

• Observational, randomized study of 607 newborns.
• Assessed pain using Neonatal/Infant Pain Scale (NIPS), cry delay, and duration.
• Measured puncture attempts and test completion time.

Main Results:

• Venepuncture showed significantly lower NIPS scores (2 vs 5) and reduced cry duration (58 vs 104 seconds).
• Venepuncture was faster (60 vs 120 seconds) and required fewer attempts.
• No significant differences in hypothyroidism false positives were observed.

Conclusions:

• Venepuncture is a less painful and more efficient method for newborn metabolic screening.
• This technique does not increase false positive rates for hypothyroidism screening.