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Universal neonatal hearing screening in Flanders reveals socio-demographic risk factors for hearing impairment
1Kind en Gezin (Child and Family), Brussels, Belgium. erwin.vankerschaver@scarlet.be
Insights
Congenital hearing impairment (CHI) affects newborns, but early screening and identifying socio-demographic risk factors improve outcomes. This Flemish program enhanced early detection and intervention for better speech and language development.
Area of Science:
- Pediatrics
- Public Health
- Audiology
Background:
- Permanent congenital hearing impairment (CHI) affects ~1.4/1000 newborns.
- Early intervention is crucial for speech and language development.
- This study details the Flemish screening program and CHI risk factors.
Purpose of the Study:
- To describe the Flemish congenital hearing impairment screening program.
- To analyze the program's results and identify socio-demographic risk factors for CHI.
- To evaluate the impact of integrating socio-demographic factors into CHI screening.
Main Methods:
- AABR screening of 628,337 newborns in Flanders (1999-2008).
- Referral for diagnostic confirmation of CHI in specialized centers.
- Investigation of socio-demographic factors as potential predictors of CHI.
Main Results:
- Referral rates ranged from 2.7-7.2 per thousand.
- 77-82% of referred babies were confirmed with hearing loss.
- Gender, birth order, maternal education, and origin were independent CHI predictors, often linked to poverty.
Conclusions:
- The integrated screening program offers new possibilities for hearing-impaired infants.
- Socio-demographic factors significantly impact CHI risk and should supplement existing lists.
- The program demonstrates considerable social impact and improves early detection.
Introduction:
Permanent congenital hearing impairment (CHI) occurs in approximately 1.4 per 1,000 newborns. Early treatment and rehabilitation is essential to prevent the delayed development of speech and language. This paper describes the special collaborative approach of the Flemish screening programme. It also discusses the results and the new insights into socio-demographic risk factors for CHI.
Methods:
In the period 1999-2008, the entire population of 628,337 newborns in Flanders was tested using an AABR hearing screener. Positive results were referred for confirmation of the CHI diagnosis to specialised referral centres. Socio-demographic factors were investigated to study any relationship with CHI.
Results:
The referral rate after two screenings was 2.7-7.2 per thousand of screened babies depending on the screener used. All children were referred to specialised centres and there was almost no loss to follow-up. The diagnosis of hearing loss was confirmed in 77-82% of the babies referred. The socio-demographic factors of gender, birth order and birth length, initial feeding type, level of education and origin of the mother were found to be independent predictors of CHI. Most of these risk factors can be linked to poverty. The observation that 50% of babies with CHI have no risk factors from the classic AAP list may be partly explained by the non-inclusion of socio-demographic risk factors.
Conclusions:
This integrated programme opens up new perspectives for hearing-impaired babies. The social impact of the screening programme is considerable. A cluster of socio-demographic risk factors for CHI can be added to the classic AAP list.
