National study of newborn hearing screening: programme sensitivity and characteristics of undetected children
A M H Korver1, S Konings2, A Meuwese-Jongejeugd3
1Willem-Alexander Children's Hospital, Department of Social Pediatrics, Leiden University Medical Center, The Netherlands. a.m.h.korver@lumc.nl
Insights
Universal newborn hearing screening (UNHS) programs detect most, but not all, infants with hearing loss. This study found UNHS sensitivity was 83%, with over half of undetected cases having moderate hearing impairment.
Area of Science:
- Audiology
- Public Health
- Pediatrics
Background:
- Universal newborn hearing screening (UNHS) programs aim for early detection of hearing loss.
- Current UNHS programs may not identify all children with permanent childhood hearing impairment.
- Evaluating UNHS program sensitivity and characteristics of undetected cases is crucial.
Purpose of the Study:
- To determine the sensitivity of the current UNHS program in The Netherlands.
- To analyze the characteristics of children with permanent hearing impairment missed by UNHS.
- To assess age at diagnosis, severity, and etiology in undetected cases.
Main Methods:
- Nationwide, population-based, retrospective follow-up study.
- Inclusion of all children born 2003-2005 screened in UNHS (well babies and NICU graduates).
- Sensitivity calculated as proportion of permanent childhood hearing impairment cases identified by UNHS by 2008.
Main Results:
- Overall UNHS program sensitivity was 0.83 (0.79 for well babies, 0.96 for NICU graduates).
- 96% of permanent childhood hearing impairment cases were confirmed before 36 months.
- Over 50% of children missed by UNHS had moderate hearing loss; no predominant cause identified.
Conclusions:
- The current UNHS program successfully identifies the majority of infants with congenital hearing loss.
- A significant proportion of children with hearing impairment, particularly moderate loss, are not detected by UNHS.
- Further improvements in UNHS are needed to capture all cases of childhood hearing impairment.
Unlabelled:
The success of universal newborn hearing screening (UNHS) programmes is usually evaluated by determining the effect of the early detection of hearing loss on developmental outcome. However, in practice, these programmes do not detect all children with permanent childhood hearing impairment. In this study we determine the sensitivity of the current UNHS programme and analyse the characteristics of the children not detected by UNHS. We performed a nationwide, population-based, retrospective follow-up study in The Netherlands. All children born in 2003-05 and screened in a hearing screening programme (well babies and neonatal intensive care (NICU) graduates) were included for study. The main outcome measure was the sensitivity of the UNHS programme (based on the proportion of children known to have a permanent childhood hearing impairment in 2008 who were identified by UNHS). We also evaluated age at diagnosis, severity, and aetiology of hearing impairment in the children not detected by UNHS. We found that the sensitivity of the current UNHS programme was 0.83 (0.79 for well babies and 0.96 for NICU graduates). Permanent childhood hearing impairment was confirmed before 36 months of age in 96% of the study cohort. Of the children unidentified by the UNHS, > 50% had moderate hearing loss. No predominant cause of hearing impairment was found in these children.
Conclusion:
Our current UNHS programme identified the majority of children with a permanent hearing impairment of congenital cause.
