Newborn Screening News

Preferred Newborn Screening Specimen

The question is occasionally asked: “Does it matter that the newborn screening blood spot is a heelstick or venous blood?”

The Newborn Screening Program follows the recommended standard and guideline published by the Clinical and Laboratory Standards Institute (CLSI) entitled, “Blood Collection on Filter Paper for Newborn Screening Programs: Approved Standard – Fifth Edition” (July 2007). This standard states, “Blood collected from the heel is preferred for newborn screening.” The standard lists two other possible sites for blood collection – dorsal hand vein and umbilical catheter (venous or arterial), but only in special situations where heel collection is not possible. It further states that the routine practice of dorsal hand vein collection is discouraged because (1) test results may vary between venous and capillary blood, (2) hand veins might be needed for IV’s, and (3) venous sampling is more invasive that a heelstick. If umbilical collections are used, the standard recommends repeat collection from the heel at a later time to verify values from the umbilical blood. One additional consideration: cut-off values of all newborn screening analytes reported by the State Public Health Laboratory are based on blood from heel collections of the Missouri infant population.

Bottom Line: Blood for newborn screening should be collected routinely by heelstick.

A copy of this CLSI publication should be available in your clinical laboratory. Also, heelstick devices, which make the procedure better for the baby and the phlebotomist, are available from medical supply vendors.

If you have question or comments, contact:

William Walden, Manager
Telephone: 573-751-2662
Email: William.Walden@dhss.mo.gov

Reviewed on Nov. 30, 2007