Capital & Coast DHB Women's Health Obstetrics & Maternity Service
Antenatal and Newborn Screening in New Zealand
Pregnant women in New Zealand currently have access to three antenatal and newborn screening programmes and one quality improvement initiative. It is a woman's choice whether to participate in screening or not, but it is recommended that discussions about screening take place early in pregnancy.
The first screening test should be discussed beforehand and offered with the first antenatal blood tests. This is a test for human immunodeficiency virus (HIV). If a woman does have HIV, she can pass the virus on to others, including her unborn baby. This test is important as it can reduce the risk of the virus being passed from mother to baby from as much as 32 percent to less than 1 percent.
The sooner a woman knows she has HIV, the sooner she can get treatment and support for herself, her partner and family or whānau and minimise the risk of passing the virus to her baby.
During the first trimester you should discuss first trimester screening for Down syndrome and other conditions. There are two screening options available. The intention of these tests is to provide a safe and reliable screening, consistent with screening offered in other countries for those women who choose to participate.
The two screening options available to New Zealand women are:
First Trimester Combined Screening, which should be offered in the first three months of pregnancy. It includes a first trimester maternal serum screening test (blood test) taken between 9 weeks and 13 weeks and 6 days of pregnancy, and a nuchal translucency scan (NT scan), carried out between 11 weeks and 13 weeks and 6 days of pregnancy. There is one combined result which indicates the chance of the woman having a baby being affected by Down syndrome or some other conditions.
The maternal serum screening blood test is fully publicly funded, however generally a surcharge applies for NT scans.
Second Trimester Maternal Serum Screening, which should be offered after 14 weeks of pregnancy have passed, or before 20 weeks of pregnancy, or to those who were not able to get a nuchal translucency scan. This test is fully funded.
The next screening programmes should be discussed before baby is born and are done just after baby is born.
Newborn Metabolic Screening is available to all New Zealand babies and is done at 48 hours of birth or as soon as possible after that. The baby’s blood is tested for rare but life-threatening disorders. This test used to be called the Guthrie test.
If the mother agrees to have the test done, a few drops of blood are taken from the baby's heel. The drops of blood are placed on a blood spot card and sent to the National Testing Centre at Auckland City Hospital for testing.
For the few who are diagnosed through the screening programme, the benefits of screening are enormous. Because the disorder is picked up early, it can often be treated before the baby becomes sick.
Newborn Hearing Screening - within one month of the baby’s birth a screening test to check the baby’s hearing will be offered. Most babies are screened before they come home from hospital. In New Zealand up to 120 babies are born each year with a moderate to severe hearing loss. Over half of babies found to have a hearing loss have no family history or any other reason to think they are at risk. Without screening it is difficult to detect hearing loss in babies until speech and language development becomes delayed.
Most babies pass their newborn hearing screening. For the few babies who need follow-up after screening, an audiology assessment is carried out. This should occur before baby is three months old. Babies found to have a moderate to severe hearing loss are able to have early interventions, such as hearing aids and special education, which can help them reach their potential. These should be started by the time baby is six months old.
Even if a baby passed newborn hearing screening, they could still develop a hearing loss later.
For more information on the screening programmes and quality initiative described in this article please go to www.nsu.govt.nz
- Antenatal and Newborn Screening Timeline (PDF, 630.5 KB)