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Newborn Screening for Five Conditions in a Tertiary Care Government Hospital in Bengaluru, South India-Three Years
Anitha Kommalur1, Sahana Devadas1, Mallesh Kariyappa1
1Department of Pediatrics, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India.
Insights
Newborn screening in India identified Glucose-6-Phosphate Dehydrogenase deficiency as the most common disorder. This study highlights the critical need for universal newborn screening programs in government hospitals.
Area of Science:
- Medical Genetics
- Neonatal Care
- Public Health
Background:
- Limited data exists on newborn screening in Indian government hospitals.
- Newborn screening is crucial for early detection of genetic disorders in developing nations.
Purpose of the Study:
- To estimate incidence and recall rates for five neonatal screening conditions in India.
- To assess the feasibility of a large-scale newborn screening program.
Main Methods:
- Retrospective analysis of 41,027 livebirths screened between January 2016 and December 2018.
- Quantitative analysis of heel-prick samples collected after 48 hours of life.
- Recall of neonates with positive screening results for confirmatory testing.
Main Results:
- Glucose-6-Phosphate Dehydrogenase (G6PD) deficiency was the most common disorder (1:414 incidence).
- Congenital hypothyroidism (1:2735) and Congenital Adrenal Hyperplasia (1:4102) were also identified.
- Galactosemia and Phenylketonuria (PKU) were rare; overall recall rate was 0.6%.
Conclusions:
- The study underscores the necessity of universal newborn screening in Indian government hospitals.
- Implementing comprehensive screening programs can improve early detection and management of neonatal disorders.
Purpose:
Newborn screening is the need of the hour in a developing country like India as there is paucity of data from studies conducted in government hospitals with large sample size. The purpose of the study is to estimate incidence rate and recall rates for five conditions screened in the neonatal period namely congenital hypothyroidism, congenital adrenal hyperplasia, glucose-6-phosphate dehydrogenase (G6PD) deficiency, galactosemia and phenyl ketonuria (PKU).
Methods:
The study was conducted at VaniVilas Hospital attached to Bangalore Medical College and Research Institute. A retrospective analysis of the results of newborn screening programme during a 3-year period between January 2016 and December 2018 was done. There were 47 623 livebirths during this period out of which 41 027 babies were screened (coverage-86% of total livebirths). Heelprick samples after 48 h of life and prior to discharge were analysed by quantitative assessment. Neonates having positive screening results were recalled by telephonic call for repeat screening and confirmatory tests.
Results:
G6PD deficiency was the most common disorder with an incidence of 1:414, followed by congenital hypothyroidism and Congenital Adrenal Hyperplasia with an incidence of 1:2735 and 1:4102, respectively. Galactosemia and PKU were found to be rare in our population. The overall average recall rate was 0.6% which meant that 24 normal newborns were recalled for testing for one confirmed case. The recall rate was relatively higher for galactosemia and G6PD deficiency which was at 0.25% each compared to the other conditions where it was below 0.05%.
Conclusion:
The results of the study emphasize the need for universal newborn screening especially in all government hospitals with large birth cohorts.
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