Evolution and expansion of newborn screening programmes in Singapore

In Singapore, the newborn screening programme was started in 1965 in order to reduce the high neonatal mortality and neurological morbidity owing to severe hyperbilirubinaemia caused by erythrocyte glucose-6-phosphate dehydrogenase deficiency. About 25 years later, the national newborn screening for congenital hypothyroidism was established. Subsequently, universal newborn hearing screening and screening for multiple inborn errors of metabolism using tandem mass spectrometry were introduced as national programmes in 2003 and 2006, respectively. All these programmes are widely accepted as standards of care, and practically every newborn is screened despite the absence of any legislation. Two other evidence-based bedside screening tests, namely pulse oximetry screening for critical congenital heart disorders and physical examination of the hips for developmental dysplasia of the hips with selected ultrasonographic screening have been widely performed in hospitals, and they are soon expected to be in the national screening programmes.