Newborn screening in North Carolina has been highly successful, identifying newborns with health conditions for which time-sensitive treatments must be provided to reduce morbidity and mortality. This issue of the North Carolina Medical Journal describes the history of newborn screening in the state, the nature of the system that must be in place for newborn screening to work as planned, and the leadership exemplified by North Carolina, both historically and now. Here we highlight some of the major challenges that newborn screening will almost surely face in the coming years. We argue that these challenges offer opportunities to advance the health of newborns in significant ways, and that partnerships among public health, the medical community, researchers, patient advocacy groups, and industry will be needed to address the complex issues that are emerging.
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