Newborn Screening Information for Providers: Blood Spot CollectionOn this page: Show
PersonnelBlood spot collection can be performed by trained personnel such as hospital nursery staff, laboratory staff, or out-of-hospital birth providers. TimingTiming of blood spot collection is important for accurately interpreting test results. Tests for some of the disorders on the newborn screening panel have different cutoff values based on the infant’s age (in hours) at the time of blood spot collection. As a result, blood spots drawn too early or too late may increase the chance of false positive or false negative results. Blood spots are best collected between 24 and 48 hours of age. Blood spots collected before 24 hours of age cannot be fully interpreted, which means some test results will be marked “unsatisfactory” on the newborn screening report. An unsatisfactory result will require another blood spot collection. Blood spots collected after 48 hours may not allow enough time for results to be interpreted before serious symptoms occur in newborns affected by certain disorders on the newborn screening panel. However, special circumstances may arise that require blood spot collection at earlier or later times. Infant should be at least 24 hours old in elapsed time, not just in "clock" time. This distinction is important on the days surrounding the switch to Daylights Saving Time. Accurate collection and recording of time is especially important with blood draws done right at 24 hours in order to avoid collecting blood before 24 hours of age. If you are collecting before 24 hours of age, please reference our Newborn Screening <24 Hour Discharge Guideline. It provides guidance about how to complete newborn screening for infants discharged to home before 24 hours of age. The Minnesota Newborn Screening Program uses blood collection standards developed specifically for newborn screening programs by the Clinical and Laboratory Standards Institute. The primary goal of these standards is to ensure the quality of blood spots collected from newborns. Poor quality specimens interfere with the screening process, potentially delaying the detection and treatment of an affected infant. If our staff receive a specimen of poor quality, we will request a repeat specimen from the birth provider. Proper specimen collection technique as outlined by the Clinical and Laboratory Standards Institute include the following steps:
Delivery Address: For clinics, out-of-hospital birth providers, and parents who submit specimens infrequently, specimens can be brought to the delivery address above or mailed to the address below. Since high heat and humidity can affect some of the tests, leaving specimens in hot mailboxes or other warm locations should be avoided. Mailing Address: Multiple newborn screening specimens may be sent together; however, a shipment should never be delayed or “batched” to wait for additional specimens. Additionally, newborn screening specimens should never be placed in the same container as other specimen types traveling to the Public Health Laboratory. Newborns Requiring TransferWithin Minnesota, birth hospitals are legally responsible for arranging to have newborn screening administered to every infant in its care. This can be accomplished by screening the newborn in the birth facility or by having a protocol in place with a receiving hospital to screen the infant. The birth hospital should screen an infant before transport in the following situations:
How to Collect Blood Spot Specimens from Newborns VideoThe following video was produced by PerkinElmer Genetics with input from the Minnesota Newborn Screening Program. This less than 5 minute video
covers how to properly collect blood spot specimens for newborn screening.
How to Collect Blood Spot Specimens from Newborns Video Text Putting Babies First VideoThe following video answers many frequently asked questions about blood spot collection, including the optimal timing of collection, drying of blood spots, and methods of collection. The video was produced in partnership by the Iowa State Hygienic Laboratory and Baby's First Test Note: This video is based on Iowa’s newborn screening protocol. Although the video states that a repeat newborn screen should be collected eight weeks after an infant’s last transfusion, we recommend that a repeat specimen be collected 90 days after the last transfusion. Please feel free to contact us with any questions.
Putting Babies First Video Text What is the proper way to dry filter paper blood spot specimens?Allow blood specimen to AIR DRY THOROUGHLY, on a horizontally level— non-absorbent open surface, such as a plastic-coated test tube rack—for a minimum of 3 hours at ambient temperature and away from direct sunlight. Do not stack, heat, or allow to touch other surfaces during the drying process.
How long should a newborn screening card be allowed to dry?Allow blood specimen to air dry for a minimum of four hours on a horizontally level, nonabsorbent, open surface at an ambient temperature of 18 degrees C to 25 degrees C.
What are the procedural steps in collecting newborn screening test?Touch the first circle on the newborn screening card gently against the large blood drop, and in one step, allow the blood to soak through the filter paper and fill the circle. Do not press the paper directly against the baby's heel. Each of the five circles need to be filled and saturated through.
What ethical considerations are important to consider in newborn screening process?The Ethical Controversies. The issues of cost, evidence, and parental consent that arose in debates about the ethics of program expansion remain central to newborn screening policy today. Cost. Concern about cost is often seen as opposed to ethics in debates about newborn screening policy.
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