Newborn hearing screening programme in Belgium: a consensus recommendation on risk factors

Area of Science:

• Neonatal care
• Audiology
• Public health

Background:

• Understanding neonatal risk factors for hearing loss is crucial for effective newborn hearing screening programs.
• Current scientific knowledge necessitated an update of these risk factors for the Belgian newborn hearing screening program.

Purpose of the Study:

• To update recommendations for clinical management and follow-up of newborns with neonatal risk factors for hearing loss.
• To inform the Belgian newborn hearing screening program with current evidence-based guidelines.

Main Methods:

• A comprehensive literature review was conducted.
• The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system was utilized to assess evidence quality and recommendation strength.
• A three-round Delphi consensus process, including online questionnaires and a face-to-face meeting, was employed.

Main Results:

• Congenital infections, family history, consanguinity, malformation syndromes, and fetal alcohol syndrome were identified as high-evidence risk factors.
• Hyperbilirubinemia was classified as a moderate-evidence risk factor.
• Very low birth weight, low Apgar scores, NICU hospitalization, and ototoxic drugs showed very low to low evidence levels, potentially due to improved management and methodological limitations.

Conclusions:

• Revised recommendations for managing and following up newborns with hearing loss risk factors were established using an evidence-based approach and expert consensus.
• The findings will be implemented into the Belgian newborn hearing screening program to prevent unidentified hearing loss.