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Updated: May 18, 2026

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Newborn screening and the obstetrician
Nancy C Rose1, Siobhan M Dolan
1Intermountain Healthcare, University of Utah School of Medicine, Intermountain Medical Center, Maternal Fetal Medicine, Salt Lake City, Utah 84157, USA. Nancy.rose@imail.org
Insights
Newborn screening identifies critical genetic disorders in infants, enabling early intervention to prevent lifelong disabilities. This vital public health program, ongoing for over 50 years, screens millions of newborns annually in the U.S.
Area of Science:
- Public Health
- Genetics
- Pediatrics
Background:
- Newborn screening is a large-scale U.S. genetic program screening ~4 million infants annually.
- Established for over 50 years, it involves state-managed programs for screening, diagnosis, and care coordination.
- Ideal screening targets disorders where early intervention prevents infant disability or death.
Purpose of the Study:
- To provide an overview of the current state of newborn screening programs.
- To highlight the 31 core conditions recommended for screening.
- To discuss the evolving landscape of newborn screening with genomic medicine and the use of residual blood spots.
Main Methods:
- Blood samples are collected from a newborn's heel onto filter paper for testing.
- Screening for core disorders is standardized, while expanded screening varies by state.
- Ongoing evaluation of new disorders for inclusion in screening panels is conducted.
Main Results:
- Currently, 31 core conditions are recommended for state newborn screening programs.
- Screening protocols are largely standardized for core disorders, but variations exist for expanded testing.
- The field is evolving with genomic medicine, necessitating consideration of chronic diseases and research use of residual samples.
Conclusions:
- Newborn screening is a critical public health initiative with a long history of development.
- Obstetric providers should educate expectant parents about the newborn screening process.
- Future directions include expanding screening with genomic advances and utilizing residual blood spots for research.
Abstract:
Newborn screening is the largest genetic screening program in the United States with approximately four million newborns screened yearly. It has been available and in continuous development for more than 50 years. Each state manages, funds, and maintains its own individual program, which encompasses newborn screening as well as the diagnosis and coordination of care for affected infants and children. The ideal disorder for screening is one in which newborn intervention prevents later disabilities or death for infants who may appear normal at birth. There are 31 core conditions that are currently recommended for incorporation into state screening programs. To obtain a sample, several drops of blood are collected from the newborn's heel and applied to filter paper. Although testing for core disorders is fairly standardized, more extensive screening varies by state and the rigorous evaluation of new disorders for inclusion in state screening panels is ongoing. As genomic medicine becomes more accessible, screening newborns for chronic diseases that may affect their long-term health will need to be addressed as well as the use of the residual blood spots for research. Obstetric providers should, at some time during pregnancy, review the basic process of newborn screening with parents to prepare them for this testing in the neonatal period. This information can be reviewed as it best suits incorporation in an individual's practice; verbal discussion and the distribution of written materials with resources for further information are encouraged.
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