EVALUATION OF AN ESTABLISHED NEWBORN SCREENING PROGRAM FOR DEVELOPMENTAL RISKS DURING A PERIOD OF CHANGES IN POST DELIVERY CARE. 610

Abstract

The effect of recent changes in post delivery care on screening for developmental risk in newborns has not been determined. Rhode Island has been screening all newborns prior to discharge since 1992. This screen classifies infants at risk (AR), not at risk (NAR) or possibly at risk (PAR) on the basis of the presence or absence of parent demographics, parent risk characteristics, child risk characteristics and handicapping conditions in the newborn. We evaluated 1) the contribution of specific screening factors in determining the developmental risk of a newborn, 2) any changes in trends in these factors during a 3 year period and 3) the impact of implementation of discharge within 24 hours of delivery. Two communities with a low socioeconomic status (SES) and the highest percentage of school children in the state receiving special education services were studied. Records from the state-sponsored screening program were analyzed for years 1993-1995. A total of 4002 newborns were screened. 56% of these were designated as AR, 15% as PAR and 29% as NAR. The percentage of newborns designated as AR and PAR were 71% in 1993, 72% in 1994 and 72% in 1995. The majority of AR and PAR infants had multiple risk factors. Less than 5% had a single risk factor. Parent demographic factors were the most prevalent risk factors. Being born to a single mother was a risk factor in 73% of the AR and PAR newborns. Discharge of newborns within 24 hours after delivery did not result in missed screenings. It appears that changes in post delivery care have not affected newborn screening for developmental risks (Supported in part by Maternal Child Health block grant).