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Published on: January 23, 2017
Socio-demographic determinants of hearing impairment studied in 103,835 term babies
Erwin Van Kerschaver1, An N Boudewyns, Frank Declau
1Medical Policy Unit, Kind en Gezin, Brussels, Belgium.
Insights
Congenital hearing impairment (CHI) affects about 1 in 1000 newborns. This study identified socio-demographic factors like gender and maternal origin as independent predictors of CHI, expanding known risk factors.
Area of Science:
- Neonatal care
- Public health
- Audiology
Background:
- Congenital hearing impairment (CHI) affects approximately 1 in 1000 newborns.
- Established risk factors include health, physical characteristics, and family history.
- The Joint Committee on Infant Hearing (JCIH) updated risk factor guidelines in 2000.
Purpose of the Study:
- To identify personal, environmental, and social factors associated with CHI prevalence.
- To expand the understanding of risk factors beyond those defined by the American Academy of Pediatrics (AAP).
Main Methods:
- A universal neonatal hearing screening (UNHS) program using automated auditory brainstem responses (AABR) was implemented for 103,835 newborns in Flanders, Belgium.
- Positive screening results were verified for CHI diagnosis in specialized centers.
- Socio-demographic data were collected and analyzed for associations with CHI.
Main Results:
- The prevalence of bilateral CHI (≥35 dB nHL) was 0.87 per 1000 newborns.
- Screening test sensitivity was 94.02% and specificity was 99.96%.
- Independent predictors of CHI included gender, birth order, birth length, feeding type, maternal education level, and maternal origin.
Conclusions:
- Socio-demographic factors identified extend the list of known risk factors for CHI.
- Incorporating these factors can help clinicians identify at-risk newborns and ensure timely follow-up.
- This expanded assessment can improve clinical decision-making and screening policies for newborn hearing impairment.
Background:
Serious hearing problems appear in approximately one in 1000 newborns. In 2000, the Joint Committee on Infant Hearing defined a list of risk factors for neonatal hearing impairment relating to health, physical characteristics and family history. The aim of this study is to determine which personal, environmental and social factors are associated with the prevalence of congenital hearing impairment (CHI).
Methods:
The entire population of 103,835 term newborns in Flanders, Belgium, was tested by a universal neonatal hearing screening (UNHS) programme using automated auditory brainstem responses (AABR). In the case of a positive result, a CHI diagnosis was verified in specialized referral centres. Socio-demographic risk factors were investigated across the entire population to study any relationship with CHI.
Results:
The prevalence of bilateral CHI of 35 dB nHL (normal hearing level) or more was 0.87/1000 newborns. The sensitivity and specificity of the screening test were 94.02 and 99.96%, respectively. The socio-demographic factors of gender, birth order, birth length, feeding type, level of education and origin of the mother were found to be independent predictors of CHI.
Conclusions:
The socio-demographic factors found to be associated with CHI extend the list of classic risk factors as defined by the American Academy of Pediatrics (AAP). Assessment of these additional factors may alert the treating physician to the increased risk of newborn hearing impairment and urge the need for accurate follow-up. Moreover, this extended assessment may improve decision making in medical practice and screening policy.
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