Improving universal newborn hearing screening outcomes by conducting it with thyroid screening.

Area of Science:

• Neonatal screening programs
• Auditory health assessment
• Public health initiatives

Background:

• Effective infant hearing screening is crucial for early detection and intervention.
• Neonatal thyroid screening is typically performed on the third to fifth day after birth, aligning with optimal timing for hearing assessments.
• Current hospital-based hearing screening may have suboptimal outcomes.

Purpose of the Study:

• To evaluate hearing screening outcomes, including referral and false positive rates, when conducted concurrently with neonatal thyroid screening at healthcare centers.
• To compare these outcomes with those of hearing screenings performed in hospitals before infant discharge.

Main Methods:

• A prospective exploratory cohort study involving 4729 newborns.
• Group 1: Infants screened for hearing in the hospital before discharge.
• Group 2: Infants referred to healthcare centers for thyroid screening, where hearing screening was also performed. Transient evoked otoacoustic emissions (TEOAE) and automatic auditory brainstem response (AABR) were utilized.

Main Results:

• The referral rate was 16.1% in the hospital group (Group 1) versus 7.6% in the healthcare center group (Group 2).
• The false positive rate was 15.9% in Group 1 compared to 7.6% in Group 2.
• Hearing screening at healthcare centers during the thyroid program demonstrated significantly lower referral and false positive rates, and a higher positive predictive value compared to hospital-based screening.

Conclusions:

• Conducting hearing screening concurrently with the neonatal thyroid screening program at healthcare centers significantly improves screening efficiency and outcomes.
• This integrated approach offers a viable and effective framework for newborn hearing screening in many countries.
• Coordinated screening post-hospital discharge presents an opportunity to enhance early detection of hearing impairments.