Adherence to follow-up recommendations for babies at risk for pediatric hearing loss
Maryrose McInerney1, Rachel Scheperle2, Wendy Zeitlin3
1Montclair State University, 1 Normal Ave, Montclair, NJ, 07043, USA; Hackensack Meridian Health, Hackensack University Medical Center, Joseph M. Sanzari Children's Hospital, 30 Prospect Ave., Hackensack, NJ, 07601, USA.
Insights
Many babies with hearing loss risk factors attend initial follow-up, but few complete monitoring. Parental engagement tools are needed to address barriers for late-onset hearing loss in infants.
Area of Science:
- Pediatrics
- Audiology
- Genetics
Background:
- Infant hearing loss is a significant concern, necessitating early detection and consistent follow-up.
- High-risk infants require ongoing monitoring to identify potential hearing impairments, including those with delayed onset.
Purpose of the Study:
- To evaluate family compliance with hearing loss monitoring recommendations for high-risk infants.
- To identify factors influencing follow-up adherence in infants with hearing loss risk factors.
Main Methods:
- Retrospective review of hearing screening and follow-up data for 604 infants over five years.
- Bivariate analyses (chi-square, t-tests, ANOVA) to determine predictors of follow-up completion.
Main Results:
- 86% attended initial follow-up, but few completed the protocol; 10.3% were diagnosed with hearing loss.
- Factors like ototoxic medication and specific syndromes predicted follow-up, while NICU stay and younger maternal age negatively predicted it.
- Infants at higher risk for delayed-onset hearing loss were followed longer, despite initial delays.
Conclusions:
- Compliance challenges exist for high-risk infants, particularly those susceptible to late-onset/progressive hearing loss.
- Targeted strategies and parental engagement tools are crucial to improve long-term monitoring adherence.
Objective:
The purpose of this retrospective study was to evaluate the families' compliance with recommendations for continued monitoring of babies with high-risk factors for hearing loss.
Methods:
Hearing screening and follow-up results from 604 babies were tracked across a five-year period. Bivariate analysis, including chi-square analysis, t-tests, and one-way analyses of variance were conducted to test whether various factors predicted likelihood of follow up.
Results:
Although 86% of the babies returned for the initial follow-up appointment, few completed the protocol or were diagnosed with hearing loss (10.3%). Excluding the babies who never returned, the average age for initial assessment was near the recommended 3-month target (3.5 months). However, babies were last seen at 9.4 months on average, which is earlier than recommended. Some factors positively predicted follow-up: receipt of ototoxic medication, hyperbilirubinemia requiring transfusion, ECMO, syndromes associated with hearing loss, craniofacial anomalies, and passing the newborn hearing screening. Others were negatively predictive: NICU stay >5 days, younger maternal age, and failing the newborn screening. There was no relationship between the results of the last test and whether the families continued with monitoring. Babies with risks categorized as more likely to be associated with delayed onset hearing loss were more often late to the initial follow up, but also followed up for a longer period of time.
Conclusions:
These results demonstrate the need to focus on the barriers unique to babies with risk factors for late onset/progressive hearing loss in addition to those barriers that generally affect loss to follow up. Tools for parental engagement are recommended.
