False-Positive Newborn Screening Result and Future Health Care Use in a State Medicaid Cohort
Premature babies with false-positive newborn screening results had more than usual acute outpatient visits between 3-12 months of age, while full-term babies with false-positive results did not, suggesting screenings may sometimes lead to health care overuse.
The 2005 expansion of mandatory newborn screenings (NBS) to 29 different disorders has raised concerns that increased false positives will raise parental anxiety and spur unnecessary utilization of health care services. This study used hospital data to identify medical services used between 3-12 months of age by all Medicaid-eligible infants born in 2006 in Michigan, 49,141 of whom had normal NBS results and 818 of whom had false-positive results. Health care in the first two months of life was not included since it could be associated with follow-up evaluation of the false positive screening.
- Gestational age is a key predictor in acute outpatient visits. Preterm infants with false-positive NBS results had significantly more acute outpatient visits between 3-12 months of age than preterm infants with normal NBS results. But there was no corresponding difference in the number of such visits between term babies with false positives and those with normal screenings.
- Gestational age was not a factor in any other type of health care visit.
- After adjustments, infants with false positive NBS were no more likely to have outpatient well visits, emergency visits or hospitalizations than their peers with normal results.
The authors hypothesize that the combination of prematurity and a false-positive NBS result may raise parental anxiety enough to lead to more acute outpatient visits. But reflecting on other possible causes, the authors underline that their study highlights “the potential complexity” of the interaction between false-positive NBS results and health care. They also note that parental anxiety caused by false-positive NBS results may have negative effects beyond the scope of this study.