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Neonatal screening for congenital metabolic and endocrine disorders : results from Germany for the years 2006–2018

Affiliation
Bavarian State Office for Health and Food Safety: Health Reporting, Epidemiology, Social Medicine,, Child Health, Screening Center, Oberschleißheim, Germany
Lüders, Anja;
Affiliation
Institute for Experimental Pediatric Endocrinology, Charité–University Medical Center Berlin, Germany
Blankenstein, Oliver;
Affiliation
Bavarian State Office for Health and Food Safety: Health Reporting, Epidemiology, Social Medicine,, Child Health, Screening Center, Oberschleißheim, Germany
Brockow, Inken;
GND
1102937231
Affiliation
Department of Child Nutrition, Federal Research Institute of Nutrition and Food, Max Rubner Institute, Karlsruhe, Department of General Pediatrics, Neonatology, and Pediatric Cardiology, University Children’s Hospital, Heinrich Heine University Düsseldorf, Germany
Ensenauer, Regina;
Affiliation
Neonatal Metabolic Screening, Hessian Center for Preventive Care in Children, Screening Center Hesse, University Hospital Frankfurt/Main, Germany
Lindner, Martin;
Affiliation
Hospital for Sick Children, University of Toronto, Canada
Schulze, Andreas;
Affiliation
Bavarian State Office for Health and Food Safety: Health Reporting, Epidemiology, Social Medicine,, Child Health, Screening Center, Oberschleißheim, Germany
Nennstiel, Uta

Background: The purpose of neonatal screening is the early detection of congenital metabolic and endocrine disorders that, if untreated, could lead to fatal crises or other long-term adverse sequelae. In Germany, neonatal screening is legally regulated. Quality-assurance reports (“DGNS reports”) are created and published annually by the German Society for Neonatal Screening (Deutsche Gesellschaft für Neugeborenen-Screening). Data from the DGNS reports for the years 2006–2018 serve as the basis of the present publication. Methods: For the years 2006–2018, prevalences were calculated and data on process quality were evaluated. Results: Among 9 218 538 births, 6917 neonates were identified who had one of the target diseases. The overall prevalence was 75 per 100 000 neonates; the disorders most commonly found were congenital hypothyroidism (30 per 100 000) followed by phenylketonuria (PKU) and medium-chain acyl-CoA dehydrogenase deficiency (MCAD) (10 per 100 000 each). Of the 272 205 follow-up screenings requested, 80% were received. The rate of positive screening findings (recall rate) declined over the observation period, from 0.90% in 2006 to 0.37% in 2018. For every five positive screening findings, one case of a target disorder was confirmed. 79% of the children for whom treatment was indicated began to receive treatment within two weeks. Conclusion: The low recall rate and the early initiation of treatment in 79% of the affected children indicate that neonatal screening for metabolic and endocrine disorders in Germany is effective. The incorporation of tracking structures and the introduction of a registry could further improve the quality of the program.

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