Expanding routine newborn screening to include a metabolic vulnerability profile could lead to earlier detection of life-threatening complications in babies born preterm, according to a study. The study led by researchers at the UC San Francisco researchers was published online in Nature Pediatric Research. The new method, which was developed at UCSF, offers valuable and time-sensitive insights into which infants are at greatest risk during their most vulnerable time, immediately after birth. The study, published in Nature Pediatric Research by scientists at the UCSF California Preterm Birth Initiative (PTBI-CA), assessed the records of 9,639 preterm infants who experienced mortality or at least one complication or mortality. Using the results of standard newborn profiles and blood tests, they identified a combination of six newborn characteristics and 19 metabolites that, together, created a vulnerability profile that reliably identified preterm babies at substantially increased risk for death and severe illness. Metabolites are molecules such as glucose or thyroid-stimulating hormone (TSH) that are naturally produced by our cells as we break down food or medications. In a newborn, these molecules may originate from the mother's bloodstream or be generated by the infant and can be used to assess whether the body is functioning normally. Of particular note are the investigative team's findings that Black babies were 35 per cent more likely than white babies to die or experience major complications, including serious breathing and digestive conditions known as respiratory distress syndrome and necrotizing enterocolitis.