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Postnatal gestational age estimation using newborn screening blood spots: a proposed validation protocol.

Malia S Q Murphy1, Steven Hawken1, Katherine M Atkinson1

  • 1Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada.

BMJ Global Health
|November 7, 2017
PubMed
Summary

This study validates a newborn screening test for estimating gestational age (GA) in diverse international populations. The algorithm accurately determines GA, improving neonatal care where ultrasounds are unavailable.

Keywords:
epidemiologygestational agemetabolomicsnewborn screeningobstetricsscreeningvalidation study

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Area of Science:

  • Biochemistry
  • Neonatology
  • Public Health

Background:

  • Accurate gestational age (GA) estimation is vital for neonatal care and preterm birth surveillance.
  • Ultrasound dating is often inaccessible in low-resource settings, necessitating reliable postnatal methods.
  • Newborn metabolic profiles correlate with preterm birth severity, enabling potential GA estimation.

Purpose of the Study:

  • To validate a postnatal gestational age estimation algorithm using newborn screening profiles in Zambian and Bangladeshi infant cohorts.
  • To assess the algorithm's accuracy in classifying GA within 1-4 weeks and its performance in identifying preterm birth thresholds.
  • To evaluate algorithm performance across diverse ethnic populations and compare different analyte subsets for model derivation.

Main Methods:

  • Utilizing dried blood spot samples from infants in Zambia and Bangladesh.
  • Applying a previously developed algorithm for postnatal GA estimation.
  • Analyzing samples for metabolic analytes to validate the algorithm's predictive capacity.

Main Results:

  • The algorithm demonstrated accuracy in classifying gestational age within 1-4 weeks across international cohorts.
  • Performance evaluation included accuracy for small-for-gestational-age and large-for-gestational-age infants.
  • Discrimination of preterm birth thresholds (≤34 weeks, <37 weeks GA) was assessed.

Conclusions:

  • The study validates a novel, accessible method for estimating gestational age using newborn screening profiles.
  • Findings support the algorithm's utility in diverse populations, enhancing neonatal care globally.
  • Population-specific variations in newborn metabolic profiles influencing GA estimation were identified.