Association between newborn screening analyte profiles and infant mortality. (4th March 2021)

• Record Type: Journal Article
• Authors: Fell, Deshayne B.; Wilson, Lindsay A.; Hawken, Steven; Spruin, Sarah; Murphy, Malia; Potter, Beth K.; Little, Julian; Chakraborty, Pranesh; Lacaze-Masmonteil, Thierry; Wilson, Kumanan
• Is Part Of: Journal of maternal-fetal & neonatal medicine. Volume 34:Number 5(2021)
• Page Start: 835
• Page End: 838
• Publication Date: 2021-03-04
• Subjects: Case-control study -- epidemiology -- infant mortality -- newborn screening -- population health; Obstetrics -- Periodicals; Perinatology -- Periodicals; Infants (Newborn) -- Diseases -- Periodicals; Neonatology -- Periodicals; 618.2
• DOI: 10.1080/14767058.2019.1615048
• Languages: English
• ISSNs: 1476-7058

Abstract

Abstract: Objective: To assess whether newborn screening analytes could be utilized beyond their traditional application to identify infants at high risk of mortality within the first 6 months of life. Methods: We linked a province-wide newborn screening registry with health administrative databases to identify infant deaths within 6 months in a source population of live-born infants between 2010 and 2014. We used a nested case-control study design, in which all infant deaths between 7 days and 6 months of age were included as cases, and a random sample of infants from the source population were selected as controls and were matched to cases at a ratio of 10:1. We examined the association between mortality and screening analytes (acylcarnitines, amino acids, fetal-to-adult hemoglobin ratio, endocrine markers, and enzymes) using lasso regression to fit multivariable models. Results: Among 350 infant deaths between 7 days and 6 months of age, and 3498 matched controls with complete data, our multivariable model demonstrated only modest ability to identify infant deaths (optimism-corrected c -statistic: 0.61, 95% confidence interval: 0.50–0.71). Conclusion: We did not find newborn screening analytes to be strongly predictive of infant mortality between 7 days and 6 months of age in the general population of newborns. Future studies should investigate whether predictive modeling within more homogeneous cause-of-death categories could lead to improved predictive ability for infant mortality.