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All procedures involving human participants in this study adhered to the ethical standards of the Declaration of Helsinki and relevant national and institutional guidelines for medical research involving human subjects. This study was a retrospective cohort study based on anonymized newborn screening data and medical records. The requirement for individual written informed consent to participate was waived by the Ethics Committee of Gansu Provincial Maternal and Child Health Hospital, because all personal identifying information was fully de-identified, and the use of existing routine clinical data posed minimal risk to participants. During data collection and follow-up, all personal and medical information of newborns was kept strictly confidential in accordance with the Personal Information Protection Law of the People\u2019s Republic of China and institutional data security regulations. 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