Missouri Guidelines for Newborn Screening Specimens
Missouri Guidelines for Newborn Screening Specimens from Premature, Low Birth Weight, Sick or NICU Infants
| Infant Category | 1st Specimen | 2nd Specimen | 3rd Specimen | 4th Specimen |
|---|---|---|---|---|
| CATEGORY – A Applies to ill or premature infants who are ≥ 34 weeks gestational age and ≥ 2,000 grams at birth |
24 – 48 hrs of age (1) |
7 – 14 days of age (2) |
N/A | N/A |
| CATEGORY – B Applies to premature infants who are < 34 weeks gestational age or < 2,000 grams at birth |
24 – 48 hrs of age (1) |
7 – 14 days of age (2) |
28 days of age (3) |
N/A |
| CATEGORY – C Applies if pre-RBC transfusion specimen is collected at < 24 hrs of age |
Collect before RBC transfusion (4) |
24 – 48 hrs after 1st RBC transfusion (5) |
7 – 14 days of age (2) |
28 days of age (If < 34 weeks gestation or < 2,000 grams at birth) (3) |
| CATEGORY – D Applies if specimen is NOT collected PRIOR to an RBC transfusion |
24 – 48 hrs after 1st RBC transfusion (5) |
7 – 14 days of age (2) |
30 days after last RBC transfusion (6) |
90 days after last RBC transfusion (7) |
Note: Infants on TPN should follow the appropriate category above regardless of TPN feeding. The above guidelines should be correlated alongside any abnormal result information received on the newborn screening laboratory reports.
KEY
Code
Description
1
Specimen supports timely detection of newborn screening conditions.
2
Missouri Department of Health Rules require a repeat newborn screen collected at 7 to 14 days-of-age on all ill and premature infants to support detection of conditions that may not have been detected in previous specimens.
3
A newborn screen collected at 28 days-of-age is recommended for all infants who are less than 34 weeks gestational age or less than 2,000 grams at birth to improve the detection of delayed onset metabolic and endocrine conditions for which ill and premature infants are at higher risk.
4
Acceptable specimen for the detection of galactosemia, hemoglobinopathies, biotinidase deficiency and fatty acid conditions.
5
Specimens necessary for the timely detection of conditions other than galactosemia, hemoglobinopathies and biotinidase defieciency.
6
Acceptable post-transfusion specimen for the detection of galactosemia and biotinidase deficiency.
7
Acceptable post-transfusion specimen for the detection of hemoglobinopathies