Singapore’s national screening programme tests newborns for metabolic and heritable diseases

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All newborns at KKH are screened under the the National Expanded Newborn Screening (Nens) programme, which involves pricking the baby’s heels to collect a blood sample between 24 and 72 hours after birth.

The screening is a preventive measure to detect health problems before symptoms appear.

ST PHOTO: VANESSA PAIGE CHELVAN

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SINGAPORE – All newborns at KK Women’s and Children’s Hospital (KKH) are screened for metabolic and heritable diseases under the National Expanded Newborn Screening (Nens) programme.

It is a preventive measure to detect health problems before symptoms appear.

The procedure – which is not legally mandated – involves pricking a baby’s heels to collect a blood sample between 24 and 72 hours after birth. 

Started in 2006, the programme was expanded in 2019 and now allows more than 40 types of diseases to be detected in newborns. These include:

  • Phenylketonuria, which gives the baby a musty smell and lighter skin and can lead to intellectual disability, seizures, behavioural problems and mental disorders

  • Glutaric acidemia type 1, which prevents the body from breaking down certain amino acids properly. This leads to a harmful build-up of substances, potentially causing brain damage and movement difficulties 

  • Congenital adrenal hyperplasia, where the body does not produce enough of the hormone cortisol, resulting in the inability to keep blood pressure, blood sugar and energy at healthy levels.

Nens can also detect other diseases, including five treatable serious childhood-onset conditions such as severe combined immunodeficiency (SCID) and cystic fibrosis.

SCID, also known as “bubble boy disease”,

is a condition where a baby is born without a functioning immune system.

Screening involves checking the baby’s blood for DNA fragments called T-cell receptor excision circles (Trecs), which show whether the immune system is producing T-cells properly. These white blood cells play a crucial role in preventing infections.

While the test does not confirm an SCID diagnosis, abnormalities such as low levels of or absent Trecs indicate that the baby needs to undergo more testing.

In 2024, all newborns at KKH were screened under Nens, while the national screening rate in Singapore is 96 per cent.

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