in high prevalence areas every pregnant woman is offered screening to see if she is a carrier of a sickle cell or other haemoglobin variant (using HPLC). In lower prevalence area this test is offered selectively according to ancestry (using a standard family origin questionnaire). Rural Devon would be a low prevalence area. Universal screening is offered for sickle cell on the newborn blood spot test. The aim is the early detection and early treatment of affected children, hence to reduce morbidity and mortality. However many newborn carriers of haemoglobin disorders will also be identified (greater than 8,500 per year in England). The screening programme may also produce other information such as variants of unknown clinical significance and suggest non-paternity
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