Antenatal and newborn screening
Screening is a process of identifying people who appear healthy but who may be at increased risk of a disease or condition. Screening helps to identify people at risk so they can get earlier, potentially more effective treatment and make informed decisions about their health and any complications arising from their condition.
NHS programmes for pregnant women include:
- screening for infectious diseases (hepatitis B, HIV, syphilis, rubella)
- screening for inherited conditions (sickle cell, thalassaemia and other haemoglobin disorders)
- screening for Down's, Edwards' and Patau's syndrome
- screening for abnormalities (18-21 week scan)
Newborns are also offered screening:
- newborn physical examination – (to detect any problems with eyes, heart, hips and, in boys, testicles)
- newborn hearing screening
- newborn blood spot screening (or ‘heel prick test’ for nine rare but serious health conditions)
The UK National Screening Programme has produced a timeline diagram showing when the different programmes are offered to women and newborns.
A helpful leaflet written by Public Health England is available in several languages which explains the various screening tests.
Key inequalities and risk factors
A review of published UK studies in 2004 (Rowe et al, 2004) found some evidence to suggest there may be inequalities in access to antenatal testing.
Some studies suggested that women of South Asian origin might be up to 70% less likely to receive prenatal testing for haemoglobin disorders and Down's syndrome than white women.
A small number of studies suggested that South Asian women might be less likely to be offered testing. This could be relevant to the Nepalese population in Bracknell Forest, concentrated in the south of the Borough.
There is also some suggestion that women with mental health issues experience challenges accessing testing, more information can be found in the NICE Guidelines CG45 (2007) Antenatal and postnatal mental health.
Facts, figures and trends
The antenatal and new-born screening programmes are commissioned at maternity unit level and the data is reported at the same level. Breaking this data down any further is likely to make it inaccurate and less reliable. Information for Heatherwood and Wexham Hospitals NHS Foundation Trust and Frimley Park Hospital NHS Foundation Trust is shown for Bracknell Forest as the majority of Bracknell Forest births were at those Trusts.
Between 2014 and 2015, of all maternities recorded in the Bracknell and Ascot CCG area, 100% received an antenatal assessment before 13 weeks to assess needs, risks and choices.
The latest quarterly figures for screening programmes can be found online at the GOV.UK NHS screening programmes: national data reporting page
Antenatal screening coverage for HIV
Since Q1 2013/14 both Frimley Park Hospital and Heatherwood and Wexham Park Hospitals have remained higher than the acceptable level of 90% for antenatal screening for HIV infection (figure 1). As of Q2 2014/15 these figures stand at 99.6% in Heatherwood and Wexham Park Hospitals and 99.1% in Frimley Park Hospital.
Figure 1: Antenatal screening for HIV infection
Source: UK National Screening Committee; UK Screening Portal - Key Performance Indicators: 2014/15 Q2 (published November 2014)
Antenatal Infectious Disease Screening- timely referral of hepatitis B positive women for specialist assessment
The national target is for 70% of women who test positive for hepatitis B to be referred for specialist assessment in a timely manner. This is the acceptable level. The numbers of women testing positive for hepatitis B during antenatal screening are relatively low so the proportions referred in a timely manner can vary quite dramatically from one time point to the next. In Berkshire, the percentage of women who are referred in a timely manner is 90.9%. This is above the acceptable level and similar to the achievable (effective) target of 90% (UK National Screening Committee; UK Screening Portal, 2014). Figures are not available at local authority level as they have been supressed to maintain patient confidentiality.
Newborn Bloodspot Screening- coverage
In Q1 2014/15 newborn bloodspot screening coverage was 96.4%. This was higher than the national acceptable target of 95% but below the achievable level of 99.9%. In Q2 2014/15 newborn bloodspot screening coverage decreased and was below the national acceptable target of 95% in Bracknell & Ascot CCG area at 93.5% (UK National Screening Committee; UK Screening Portal, 2014). This data needs to be kept under regular review to make sure coverage returns to above the acceptable target in subsequent quarters.
Data prior to 2014/15 was shown at PCT level only and so no direct comparisons can be made.
Antenatal sickle cell and thalassaemia screening- coverage
Screening coverage for antenatal sickle cell and thalassaemia has remained above the national acceptable level of 95% in both Heatherwood and Wexham Park Hospitals and Frimley Park Hospital (figure 2). As of Q2 2014/15 the figure for Frimley Park Hospital was 98.8%. The figure for Heatherwood and Wexham Park Hospitals was 99.6%, which is slightly higher than the achievable target of 99%.
Figure 2: Antenatal sickle cell and thalassaemia screening
UK National Screening Committee; UK Screening Portal - Key Performance Indicators: 2014/15 Q2 (published November 2014)
Newborn hearing screening coverage
Coverage for newborn hearing screening is shown at county level. This shows the proportion of babies eligible for newborn hearing screening for whom the screening process is complete by 4 weeks corrected age (hospital programmes - well babies, neonatal intensive care unit (NICU) babies) or by 5 weeks corrected age (community programmes-well babies). In Berkshire coverage is at 98%. This is similar to both the South East and England average and is higher than the acceptable target. The achievable target for this screening is 99.5%.
Want to know more?
Antenatal Care (NICE, 2008) - Guidelines cover advice and information to be given to women during pregnancy, including antenatal and newborn screening programmes, screening for clinical conditions such as gestational diabetes and pre-eclampsia, screening for infections, lifestyle advice, provision of care and management of pregnancy symptoms and breastfeeding
Antenatal and postnatal mental health (NICE, 2007) - Guidelines provide recommendations for predicting, diagnosing and treating women with mental health problems in the antenatal and postnatal periods.
In considering how to deliver services, the evidence tables supporting the NICE Guidelines CG62 (2008) Antenatal Care suggest that more effective reach to different income or ethnic groups could be achieved through smaller, informal, group health education classes, delivered in the antenatal period, to increase initiation rates, and in some cases the duration of breastfeeding.
Health Matters: Giving every child the best start in life (accessed 8 June 2016) is a resource for parents and professionals using or commissioning services, which brings together important facts, figures and evidence of effective interventions to tackle issues arising in the period from pregnancy to the age of two.
This page was created on 4 August 2014 and updated on 16 June 2016. Next review due June 2017.
Cite this page:
Bracknell Forest Council. (2016). JSNA – Antenatal and Newborn Screening. Available at: jsna.bracknell-forest.gov.uk/starting-well/maternity/antenatal-and-newborn-screening (Accessed: dd Mmmm yyyy)
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