A 25-Year Retrospective on Bavaria's Newborn Screening Programme: Achievements, Challenges and Long-Term Follow-Up.

The German federal state of Bavaria implemented newborn screening (NBS) using dried blood spots (DBS) as an integrated public health programme with centralised coordination. The Bavarian NBS Centre collaborates with NBS laboratories, obstetric and paediatric facilities, specialised centres of expertise, and parents. It is responsible for coordination, evaluation, quality assurance, and a long-term follow-up study. In this paper, an analysis of NBS in Bavaria from 1999 to 2023 and a long-term follow-up for the birth cohort until 2013 is presented. Of the 2,854,190 babies screened, 2500 were diagnosed and treated early thanks to NBS. An NBS coverage rate of 99.83% was achieved, with 99.09% of all requested repeat tests completed. Around 87% of infants with time-sensitive conditions underwent a clinical intervention within the first 14 days of life. Systematic tracking enabled all but 54 NBS-positive results to be clarified and 122 newborns to be diagnosed in due time. The results of the long-term follow-up study demonstrate that almost all the children identified through NBS receive ongoing medical care, and that NBS has contributed to the age-appropriate development of most affected children. This 25-year evaluation of NBS in Bavaria shows that near-universal participation in NBS and follow-up of almost all positive NBS results can be achieved through centralised coordination and ongoing cooperation of all those involved.