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Main outcomes of a newborn hearing screening program in Belgium over six years
Bénédicte Vos1, Raphaël Lagasse2, Alain Levêque3
1Université libre de Bruxelles, School of Public Health, Research Center Health Policy and Systems - International Health, Route de Lennik 808, Brussels 1070, Belgium; Centre d'Epidémiologie Périnatale (CEpiP), Route de Lennik 808, Brussels 1070, Belgium.
Insights
Belgium's newborn hearing screening program showed positive early improvements but did not meet international benchmarks. Continued professional support is crucial for enhancing screening outcomes and program quality for infants.
Area of Science:
- Public Health
- Pediatrics
- Audiology
Background:
- The implementation of newborn hearing screening programs is vital for early detection of hearing loss in infants.
- Assessing program outcomes and their evolution is essential for quality improvement and meeting established benchmarks.
Purpose of the Study:
- To evaluate the outcomes of Belgium's newborn hearing screening program (French-speaking area) from 2007 to 2012.
- To analyze the program's evolution in a neonatal population without known risk factors for hearing loss.
Main Methods:
- Descriptive, retrospective analysis of six annual databases (2007-2012) from the newborn hearing screening program.
- Key outcomes assessed: hearing impairment prevalence, screening coverage rates (initial, second, follow-up), conclusive test proportions, and referral rates.
- Statistical analysis using Chi-squares to identify temporal trends in outcomes.
Main Results:
- Over 264,508 newborns were screened; hearing impairment prevalence was 1.41‰, with annual variations.
- Initial screening coverage increased from <90% to ~95% over the study period.
- Referral rate stabilized around 2.40%, while follow-up rates improved from 44.91% to over 70% but remained below target.
Conclusions:
- Belgium's newborn hearing screening program outcomes were below Joint Committee on Infant Hearing benchmarks.
- The program demonstrated positive evolution, particularly in initial years, with improvements in coverage and follow-up.
- Sustained professional commitment and support are necessary to further enhance screening outcomes and program quality.
Objective:
To present the outcomes of the newborn hearing screening program in Belgium (French-speaking area) since its implementation and to analyze its evolution between 2007 and 2012 in the neonatal population without reported risk factors for hearing loss.
Methods:
The study was descriptive and based on a retrospective analysis of six annual databases (2007-2012) from the newborn hearing screening program. The main outcomes were identified: prevalence of reported hearing impairment; coverage rates (first and second test, follow-up); proportions of conclusive screening tests; referral rate. Each outcome was presented for the six years and by year of birth. Chi-squares were used to study differences in the various outcomes according to time.
Results:
Over the six years, 264,508 newborns were considered as eligible for the screening. Hearing impairment was confirmed in 1.41‰ (n = 374) of them, with significant disparities from year to year, between 0.67‰ and 1.94‰. Analysis of the screening process showed that only 92.71% (n = 245,219) of the eligible newborns underwent a first hearing test. This coverage rate varied greatly over time: at the beginning, less than 90% of the newborns had a first test and it rose to almost 95%. After the two screening steps, 2.40% (n = 6340) of the newborns were referred to an ENT doctor; the referral rate slightly decreased during the first years of the program and then stabilized around 2.4%. Over the period, only 62.21% of the referred newborns had a follow-up; the follow-up rate was particularly low for the first year (44.91%) and then strongly increased (+19.52% in 2008) but never exceeded 70%.
Conclusions:
Outcome measures for the newborn hearing screening program in Belgium are lower than the benchmarks released by the Joint Committee on Infant Hearing. Nevertheless, the evolution of the outcome measures since the implementation of the program has been positive, particularly during the first years. At some point, most of the outcome measures decreased or at least did not change any further. The motivation and commitment of the professionals have to be supported in a variety of ways to improve outcome measures and thus, the quality of the program.
