German newborn screening for Cystic fibrosis: Parental perspectives and suggestions for improvements

Pediatr Pulmonol. 2023 Mar;58(3):844-852. doi: 10.1002/ppul.26263. Epub 2022 Dec 12.

Abstract

Purpose: Cystic fibrosis (CF) was added to the German newborn bloodspot screening (NBS) panel in 2016. This study assesses parental perceptions of CF-NBS and confirmatory testing.

Methods: Prospective questionnaire-based survey administered to parents of children with positive CF-NBS over 40 months after initiation of CF-NBS in Southwest Germany. Parental perceptions were compared to results from Bavaria and Switzerland.

Results: Questionnaires with 29 standardized questions were sent to 343 families with children born between October 2016 and January 2020. A total of 178 (51.9%) replied. Although required by law, only a minority were informed about CF-NBS by a physician. The information provided about NBS was sufficient for 78% of parents. Regarding the information about positive CF-NBS, 52.9% were satisfied but the majority expressed negative emotions (89.5%). While most of these were resolved after confirmatory diagnostics, 17% of parents of children with false-positive CF-NBS and 66.7% of children confirmed with CF remained anxious. Waiting time for sweat testing was >3 days in 56.1%, considerably longer than in more centralized screening systems. Parents who waited for a maximum of 3 days were significantly more satisfied. 70.7% of parents were satisfied with the information given during confirmatory diagnostics and 91.4% were satisfied with participating in CF-NBS.

Conclusions: CF-NBS stands in high regard with parents. Smooth organization, timely initiation of confirmatory testing, and professional communication are most important to limit parental anxiety. A more centralized system of confirmatory diagnostics appears advantageous in several regards as it reduces time from positive NBS to final diagnosis and increases parental satisfaction.

Keywords: Cystic fibrosis; Germany; children; confirmatory diagnostics; family; newborn screening; parental perspectives; pulmonology.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anxiety
  • Child
  • Cystic Fibrosis* / diagnosis
  • Cystic Fibrosis* / psychology
  • Humans
  • Infant, Newborn
  • Neonatal Screening* / methods
  • Parents / psychology
  • Prospective Studies