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World Journal of Pediatrics

, Volume 14, Issue 5, pp 470–481 | Cite as

High incidence of maternal vitamin B12 deficiency detected by newborn screening: first results from a study for the evaluation of 26 additional target disorders for the German newborn screening panel

  • Gwendolyn Gramer
  • Junmin Fang-Hoffmann
  • Patrik Feyh
  • Glynis Klinke
  • Peter Monostori
  • Jürgen G. Okun
  • Georg F. Hoffmann
Original Article

Abstract

Background

Newborn screening (NBS) in Germany currently includes 15 target disorders. Recent diagnostic improvements suggest an extension of the screening panel.

Methods

Since August 2016, a prospective study evaluating 26 additional target disorders (25 metabolic disorders and vitamin B12-deficiency) in addition to the German screening panel is performed at the Newborn Screening Center Heidelberg. First-tier results from tandem-MS screening are complemented by second-tier strategies for 15 of the additional target disorders. NBS results of seven patients diagnosed symptomatically with one of the additional target disorders by selective screening since August 2016 are retrospectively evaluated.

Results

Over a 13-month period, 68,418 children participated in the study. Second-tier analyses were performed in 5.4% of samples. Only 59 (0.1%) of study participants had abnormal screening results for one of the additional target disorders. Target disorders from the study panel were confirmed in 12 children: 1 3-hydroxy-3-methylglutaryl coenzyme A (CoA)-lyase deficiency, 1 citrullinemia type I, 1 multiple acyl-CoA dehydrogenase-deficiency, 1 methylenetetrahydrofolate reductase-deficiency, and 8 children with maternal vitamin B12-deficiency. In addition, six of seven patients diagnosed symptomatically outside the study with one of the target disorders would have been identified by the study strategy in their NBS sample.

Conclusions

Within 13 months, the study “Newborn Screening 2020” identified additional 12 children with treatable conditions while only marginally increasing the recall rate by 0.1%. Maternal vitamin B12-deficiency was the most frequent finding. Even more children could benefit from screening for the additional target disorders by extending the NBS panel for Germany and/or other countries.

Keywords

Metabolic disorders Newborn screening Second-tier Vitamin B12 deficiency 

Notes

Author contributions

GG contributed to study design, collection, evaluation and interpretation of data, drafting and writing of the manuscript. JFH contributed to contribution and interpretation of data, and revision of the manuscript. PF contributed to study design, data acquisition and management, and revision of the manuscript. PM and GK contributed to development of the laboratory methods, contribution and interpretation of data, and revision of the manuscript. JGO  contributed to study design, development of the laboratory methods, and revision of the manuscript. GFH contributed to study design, interpretation of data, and revision of the manuscript. All authors approved the final version of the manuscript.

Funding

This study is generously supported by the Dietmar Hopp Foundation, St. Leon-Rot, Germany. The authors confirm independence from the sponsor; the content of the article has not been influenced by the sponsor.

Compliance with ethical standards

Ethical approval

The study “Newborn Screening 2020” as well as retrospective evaluation of NBS results of patients diagnosed by selective screening has been approved by the Ethics Committee of the University Hospital Heidelberg (no. S-533/2015). Written informed consent was obtained from parents before participation of children in the study “Newborn Screening 2020”.

Conflict of interest

GG received a lecture fee from MetaX, Friedberg; JFH, PF, GK, PM, JGO, and GFH report no disclosures.

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Copyright information

© Children's Hospital, Zhejiang University School of Medicine 2018

Authors and Affiliations

  • Gwendolyn Gramer
    • 1
  • Junmin Fang-Hoffmann
    • 1
  • Patrik Feyh
    • 1
  • Glynis Klinke
    • 1
  • Peter Monostori
    • 1
  • Jürgen G. Okun
    • 1
  • Georg F. Hoffmann
    • 1
  1. 1.Division of Neuropediatric and Metabolic Medicine, Department of General Pediatrics, Center for Pediatric and Adolescent MedicineUniversity Hospital HeidelbergHeidelbergGermany

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