Newborn Screening (NBS) – 5 Biochemical & Haemoglobinopathies Test: Booking, Price, and Results
About Newborn Screening (NBS) – 5 Biochemical & Haemoglobinopathies Test: Booking, Price, and Results
| Field | Value |
|---|---|
| Also Known As | NBS-5 Test, Neonatal Metabolic Screening Panel |
| Sample Type | Heel-prick blood sample |
| Fasting Required | Not required |
| Report Time | 3 to 7 days |
| Recommended For | All newborns (both genders), ideally 24 to 48 hours after birth |
| Price | Starting at ₹1,200 |
What Is a Newborn Screening (NBS) – 5 Biochemical & Haemoglobinopathies Test?
The newborn screening (NBS) – 5 biochemical & haemoglobinopathies test is an early screening panel performed on newborn babies to check for five metabolic conditions and inherited blood disorders. A few drops of blood are collected from the baby's heel and placed on a special filter paper card. The test is also known as the NBS-5 test or the neonatal metabolic screening panel. It is recommended for all newborns, ideally within 24 to 48 hours of birth.
What Does a Newborn Screening (NBS) – 5 Biochemical & Haemoglobinopathies Test Measure?
The NBS-5 test checks six key markers from the heel-prick blood sample. Here is what each one tells us:
| Parameter | What It Means |
|---|---|
| 17-Hydroxyprogesterone (17-OHP) | A steroid hormone; high levels may point to congenital adrenal hyperplasia (CAH), where the adrenal glands do not make enough cortisol |
| Immunoreactive Trypsinogen (IRT) | A pancreatic substance; elevated levels may suggest cystic fibrosis, a genetic condition causing thick mucus build-up in the lungs and digestive system |
| Phenylalanine (Phe) | An amino acid from food; raised levels may indicate phenylketonuria (PKU), where the body cannot break down this amino acid safely |
| Galactose (GAL) | A sugar found in milk; high levels may signal galactosaemia, where the body cannot process galactose properly |
| Thyroid-Stimulating Hormone (TSH) | A hormone that controls the thyroid gland; elevated levels may indicate congenital hypothyroidism, an underactive thyroid present from birth |
| Haemoglobin Variants | Identifies different forms of haemoglobin (the oxygen-carrying protein in red blood cells) to screen for sickle cell disease, thalassaemia, and related blood disorders |
Why Is a Newborn Screening (NBS) – 5 Biochemical & Haemoglobinopathies Test Done?
The purpose of the neonatal metabolic screening panel is to identify serious conditions before symptoms appear so that treatment can begin as early as possible.
Common Symptoms That May Require This Test
Because many of these conditions show no visible signs at birth, the NBS-5 test is recommended for all newborns rather than only those with symptoms. In affected infants who are not screened, symptoms may include:
- Poor feeding or refusing feeds
- Unusual sleepiness or low energy (lethargy)
- Persistent vomiting
- Yellowing of the skin or eyes (jaundice)
- Seizures or abnormal movements
- Failure to gain weight as expected
- Delayed development milestones
Conditions This Test Can Help Detect
The newborn screening (NBS) – 5 biochemical & haemoglobinopathies test screens for the following conditions:
- Congenital adrenal hyperplasia (CAH), caused by inherited defects in steroid production
- Cystic fibrosis, a genetic condition affecting the lungs and digestive system
- Phenylketonuria (PKU), where phenylalanine builds up to levels that can harm the brain
- Galactosaemia, a metabolic disorder affecting how the body processes milk sugar
- Congenital hypothyroidism, an underactive thyroid gland present from birth
- Sickle cell disease, thalassaemia, and other inherited blood disorders
How to Prepare and What to Expect
Preparing a newborn for this test is straightforward, and the process is quick and safe.
Do You Need to Fast?
No fasting is required. The baby should be well fed before the sample is taken, as adequate feeding helps ensure accurate metabolite levels in the blood. However, always follow specific instructions provided by your doctor or laboratory at the time of booking.
Practical Tips Before Your Test
Keep these points in mind before your baby's sample is collected:
- The ideal window for testing is 24 to 48 hours after birth; testing before 24 hours may require a repeat sample
- Ensure the baby is warm and comfortable to help blood flow to the heel
- Avoid applying any lotions or creams to the baby's heel before collection
- Let the healthcare provider know if the baby was born premature or has received a blood transfusion, as this may affect results
- Inform the provider of any treatments or medications the baby has received
Step-by-Step Procedure
- A healthcare professional gently warms the baby's heel to improve blood flow.
- A small, safe device with a tiny needle is used to make a quick prick on the heel.
- A few drops of blood are collected onto special filter paper, filling the marked circles on the card.
- The blood spots are left to dry completely at room temperature.
- The dried blood spot card is labelled and sent to a laboratory for analysis.
- Results are typically available within 3 to 7 days from the time the sample is received.
Factors That Can Affect Accuracy
- Collection before 24 hours of age can produce false positive or false negative results
- Premature birth or low birth weight may cause elevated 17-OHP levels, leading to a false positive for congenital adrenal hyperplasia
- Blood transfusions before screening can affect haemoglobinopathy detection
- Improper storage of the dried blood spot card (exposure to heat or humidity) may affect enzyme activity results
- Feeding the baby before the test is important for reliable galactosaemia screening
Understanding Your Newborn Screening (NBS) – 5 Biochemical & Haemoglobinopathies Test Results
Results should always be reviewed with a paediatrician. The table below shows the interpretation of the test results:
1. Biochemical Screening Interpretation
| Test | Normal Range | Abnormal Findings | Possible Condition |
|---|---|---|---|
| 17-Hydroxyprogesterone (17-OHP) | ≤ 30 ng/mL | ↑ Elevated | Congenital Adrenal Hyperplasia (CAH) |
| Immunoreactive Trypsinogen (IRT) | < 60 ng/mL | ↑ Elevated | Cystic Fibrosis (CF) (Confirm with sweat chloride test) |
| Phenylalanine (Phe) | < 2 mg/dL | ↑ Elevated | Phenylketonuria (PKU) |
| Galactose (GAL) | < 10 mg/dL | ↑ Elevated | Galactosaemia |
| Thyroid-Stimulating Hormone (TSH) | < 10 µIU/mL | ↑ Elevated | Congenital Hypothyroidism (CH) |
2. Haemoglobinopathy Screening Interpretation
| Haemoglobin Type | Interpretation | Possible Condition |
|---|---|---|
| HbA & HbF (Normal) | No abnormal haemoglobin detected | Normal |
| HbF only | Possible β-Thalassaemia Major | Requires follow-up |
| HbS detected | Possible Sickle Cell Disease (SCD) or Sickle Cell Trait | Confirm with molecular testing |
| HbE, HbC, or HbD detected | Possible Haemoglobinopathy (Thalassaemia and Hb Variants) | Further evaluation needed |
These ranges are general guidelines. Your doctor will interpret your results based on your baby's age, birth weight, gestational age, and health history. Always consult a qualified healthcare professional for personalised medical advice.
Results During Special Conditions
Certain circumstances can affect how results are read:
- In preterm infants, 17-OHP levels may be falsely elevated due to cross-reactivity with substances produced by the immature adrenal gland.
- TSH levels can be temporarily high in newborns tested within the first 24 hours, owing to a natural TSH surge that occurs after birth in response to cold.
- A prior red blood cell transfusion can interfere with haemoglobin testing and may also affect galactosaemia screening for up to three months.
- Low birth weight and serious illness at the time of testing can alter multiple screening parameters.
How to Maintain Healthy Levels
These general tips support your baby's health in the newborn period:
- Ensure your baby is fed regularly with breast milk or formula, both before and after sample collection.
- Attend all scheduled well-baby visits so your paediatrician can monitor growth and development.
- If any screening result is outside the normal range, follow up promptly with the confirmatory tests your doctor recommends.
Lupin Diagnostics Newborn Screening (NBS) – 5 Biochemical & Haemoglobinopathies Test Price and Home Collection
The newborn screening (5 biochemical & haemoglobinopathies) (NBS-5) test price starts at ₹1,200 and is available with home collection across major Indian cities. The table below shows indicative prices across major Indian cities:
| City | Approximate Price (₹) |
|---|---|
| Mumbai | ₹2100 |
| Bengaluru | ₹1200 |
| Hyderabad | ₹1200 |
| Chennai | ₹1200 |
| Kolkata | ₹1200 |
| Pune | ₹1200 |
Prices are indicative and may vary by location. Please confirm the current price at the time of booking.
How to Book
- Select the test on the Lupin Diagnostics website.
- Choose your city and preferred time slot.
- Opt for home sample collection by a certified phlebotomist, or visit your nearest Lupin Diagnostics centre.
- Receive your report via email or WhatsApp within the stipulated turnaround time.
Home Collection
Lupin Diagnostics offers home collection for the newborn screening (NBS) – 5 biochemical & haemoglobinopathies test across cities, so a trained phlebotomist visits your home to collect the heel-prick sample. All samples are processed in NABL-accredited laboratories to ensure accuracy and reliability. Digital reports are shared via email or WhatsApp once ready.
Frequently Asked Questions
The newborn screening (NBS) – 5 biochemical & haemoglobinopathies test should ideally be done between 24 and 48 hours after birth. Testing before 24 hours may lead to inaccurate results, and a repeat sample may be needed. If the window is missed, the test can still be performed after 48 hours.
Your baby may cry briefly when the heel is pricked, but the discomfort passes very quickly and leaves no mark. Holding or breastfeeding the baby during the procedure can help provide comfort.
An abnormal result does not mean your baby has been diagnosed with a condition. It means further confirmatory tests are needed to investigate. Your paediatrician will explain the next steps and guide you through any additional testing required.
Yes, premature babies can be tested. However, some parameters such as 17-OHP may be falsely elevated, and TSH elevation may be delayed due to an immature hormonal system. Laboratories use adjusted cutoffs for preterm infants, and a repeat test is often recommended.
Early identification of conditions such as sickle cell disease and thalassaemia through a neonatal metabolic screening panel allows treatment to begin promptly. Studies show that early detection and care significantly reduce serious complications and mortality in affected children.
No fasting is needed. In fact, the baby should have had some milk feeds before the test. Milk intake is necessary for accurate galactosaemia screening, so avoid collecting the sample before any feeding has occurred.
Newborn Screening (NBS) – 5 Biochemical & Haemoglobinopathies Test: Booking, Price, and Results
