TY - JOUR
T1 - Implementation of Universal Screening for G6PD Deficiency in Newborns
AU - Milburn, Sarah
AU - Bhutani, Vinod K.
AU - Weintraub, Andrea
AU - Guttmann, Katherine
N1 - Publisher Copyright:
© 2024 by the American Academy of Pediatrics
PY - 2024/8/1
Y1 - 2024/8/1
N2 - We describe the implementation of universal glucose-6-phosphate dehydrogenase (G6PD) screening during the first year of New York State mandated testing, as well as operational challenges and clinical knowledge gained. All infants born at or transferred to our center between June 21, 2022 and June 30, 2023, underwent testing for G6PD enzyme deficiency and were included in the study cohort. Infant blood samples were collected and sent to a reference laboratory for quantitative assay. After initiation of universal screening, a quality improvement initiative was launched to: 1. monitor and improve the suitability of blood sample collection to ensure timely return of results; 2. improve the reliability and validity of the reference laboratory enzyme assay; and 3. establish accurate reference ranges for G6PD deficiency in newborns. A total of 5601 newborns were included. Within the first year of implementation, the percentage of samples yielding any test result increased from 76% to 85%, and most patients had a G6PD result available within 1 day of discharge. We established a more accurate threshold for G6PD deficiency in newborns of <4.9 U/g Hb and G6PD intermediate of <10.0 U/g Hb. Using the updated reference ranges, 224 patients in our cohort were identified as G6PD deficient or intermediate (4.0%). Through a quality-sensitive process, we identified the importance of a standardized approach, improved sample collection processes, decreased sample turnaround time, and established more accurate reference ranges. We hope our experiences will help others seeking to improve processes and implement similar programs at other institutions.
AB - We describe the implementation of universal glucose-6-phosphate dehydrogenase (G6PD) screening during the first year of New York State mandated testing, as well as operational challenges and clinical knowledge gained. All infants born at or transferred to our center between June 21, 2022 and June 30, 2023, underwent testing for G6PD enzyme deficiency and were included in the study cohort. Infant blood samples were collected and sent to a reference laboratory for quantitative assay. After initiation of universal screening, a quality improvement initiative was launched to: 1. monitor and improve the suitability of blood sample collection to ensure timely return of results; 2. improve the reliability and validity of the reference laboratory enzyme assay; and 3. establish accurate reference ranges for G6PD deficiency in newborns. A total of 5601 newborns were included. Within the first year of implementation, the percentage of samples yielding any test result increased from 76% to 85%, and most patients had a G6PD result available within 1 day of discharge. We established a more accurate threshold for G6PD deficiency in newborns of <4.9 U/g Hb and G6PD intermediate of <10.0 U/g Hb. Using the updated reference ranges, 224 patients in our cohort were identified as G6PD deficient or intermediate (4.0%). Through a quality-sensitive process, we identified the importance of a standardized approach, improved sample collection processes, decreased sample turnaround time, and established more accurate reference ranges. We hope our experiences will help others seeking to improve processes and implement similar programs at other institutions.
UR - http://www.scopus.com/inward/record.url?scp=85200423530&partnerID=8YFLogxK
U2 - 10.1542/peds.2024-065900
DO - 10.1542/peds.2024-065900
M3 - Article
C2 - 38988309
AN - SCOPUS:85200423530
SN - 0031-4005
VL - 154
JO - Pediatrics
JF - Pediatrics
IS - 2
M1 - e2024065900
ER -