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[Universal neonatal hearing screening of infants with otoacoustic emissions]
Sven-Harald Anderssen1, Jannicke Andresen, Ronny Andersen
1Barneavdelingen, Sykehuset Østfold 1603 Fredrikstad. s-hander@online.no
Insights
Universal newborn hearing screening in Norway is effective, identifying congenital hearing impairment at a rate of 1.6 per 1,000 infants. Adding automated auditory brainstem response (AABR) may reduce parental refusals.
Area of Science:
- Pediatrics
- Audiology
- Public Health
Context:
- Congenital hearing impairment affects 1-2/1,000 newborns, necessitating early detection.
- Universal newborn hearing screening programs are established globally but were absent in Norway.
- This study presents the first report on universal newborn hearing screening in Norway.
Purpose:
- To evaluate the feasibility and effectiveness of a universal newborn hearing screening program in Norway.
- To determine the incidence of congenital hearing impairment in a Norwegian population.
- To assess the suitability of otoacoustic emission (OAE) testing in a two-step screening model.
Summary:
- A two-step otoacoustic emission (OAE) screening model was implemented for 5,712 newborns in Østfold County.
- 98.8% of infants were screened, with a 97.0% pass rate after two OAE tests.
- Congenital hearing impairment was diagnosed in 1.6/1,000 infants (sensorineural: 1.0/1,000; conductive: 0.6/1,000).
Impact:
- The implemented screening model is appropriate and cost-effective for identifying congenital hearing impairment.
- The incidence of hearing impairment aligns with international findings.
- Recommendations include reducing parental refusals by potentially incorporating automated auditory brainstem response (AABR) testing.
Background:
The incidence of congenital hearing impairment is 1-2/1,000--higher than for congenital hypothyroidism and phenylketonuria combined. Universal screening of hearing impairment has been introduced in many countries with portable otoacoustic emission (OAE) and/or automated auditory brainstem response (AABR), but not in Norway. This is the first Norwegian report on universal hearing screening of newborns before hospital discharge.
Materials And Methods:
All newborns in Østfold County (n = 5,712) in 2000 and 2001 were offered an OAE test on the second day in nursery by a two-step model. After two tests without OAE signals bilaterally, the infants were referred to the audiology clinic.
Results:
98.8% of the newborns were tested. Of these, 97.0% had a pass response after two tests. 169 (3.0%) were referred to the audiology clinic; 15 were withdrawn from follow-up examination by their parents. 23 infants had auditory brainstem response audiometry done, and sensorineural hearing impairment was found in six (1.0/1,000). Three infants (0.6/1,000) had conductive hearing impairment.
Interpretation:
Our screening model was appropriate and cost-effective. The incidence of congenital hearing impairment was similar to that reported by others. The number of parental refusals should be reduced. This may be achieved by adding an AABR to the two OAE tests.