Published online June 1, 2006
PEDIATRICS Vol. 117 No. 6 June 2006, pp. 1915-1921 (doi:10.1542/peds.2005-2294)
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Expanded Newborn Screening for Biochemical Disorders: The Effect of a False-Positive Result

Elizabeth A. Gurian, BSa, Daniel D. Kinnamon, MSb, Judith J. Henry, MSN, RNc and Susan E. Waisbren, PhDd

a Departments of Medicine
d Psychiatry
b Clinical Research Program, Children's Hospital Boston, Boston, Massachusetts
c Pediatrix/NeoGen, Bridgeville, Pennsylvania

BACKGROUND. Newborn screening programs now identify children with >30 biochemical genetic disorders. False-positive identifications may increase as disorders are added to screening panels. Concerns arise regarding the potential impact on parental stress, family relationships, and perceptions of the child's health.

METHODS. Parents of 173 infants with false-positive screening results for a biochemical genetic disorder in the expanded newborn screening panel were compared with parents of 67 children with normal screening results. Parents completed an interview that elicited information about demographic features, child and parental health, and understanding of newborn screening. Parents also completed the parenting stress index.

RESULTS. Parents in the false-positive group attained higher total scores on the PSI than did parents in the normal-screened group, scoring higher on the parent-child dysfunction subscale and the difficult child subscale. Only approximately one third of parents in the false-positive group reported knowing the correct reason for repeat screening. Mothers who reported knowing the correct reason for their child's repeat screening test experienced less total stress than did mothers who were misinformed, were not informed, or did not remember.

CONCLUSIONS. False-positive screening results may affect parental stress and the parent-child relationship. Improved communication with parents regarding the need for repeat screening tests may reduce the negative impact of false-positive results.

Key Words: newborn screening • false-positive • parental stress • vulnerable child • nocebo phenomenon • parent-child relationship

Abbreviations: PKU—phenylketonuria • PSI—parenting stress index

Accepted Nov 17, 2005.


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