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A regional-based newborn hearing screening program: the Emilia-Romagna model after ten years of legislation
G Bianchin1, S Palma2, V Polizzi1
1Department of Audiology, Santa Maria Nuova Hospital, Center for Clinical and Basic Research (IRCCS), Reggio Emilia, Italy.
Insights
Newborn hearing screening in Emilia Romagna achieved over 99% coverage, identifying 3.7/1,000 infants with hearing loss. This regional program demonstrates value and cost-effectiveness for early detection.
Area of Science:
- Pediatrics
- Public Health
- Audiology
Background:
- Congenital hearing loss affects 1-3/1,000 newborns, necessitating early detection through screening.
- Newborn Hearing Screening (NHS) is the primary method for early identification of hearing loss in infants.
- The Emilia Romagna Regional Health Agency mandated NHS for all newborns since 2011.
Purpose of the Study:
- To analyze the outcomes of a regional Newborn Hearing Screening program.
- To evaluate the impact of legislative support on the program's organization and effectiveness.
- To assess the prevalence and characteristics of hearing loss in newborns within the region.
Main Methods:
- An observational retrospective chart study was conducted from January 1st, 2015, to December 31st, 2020.
- Data included NHS coverage, otoacoustic emissions referral rates, hearing loss prevalence, laterality, and audiological risk factors.
- The study encompassed well-babies and infants from Neonatal Intensive Care Units.
Main Results:
- Newborn Hearing Screening coverage exceeded 99% for 198,396 newborns between 2015-2020.
- A total of 745 children were diagnosed with hearing loss, a prevalence of 3.7/1,000 infants.
- Confirmed hearing loss cases represented 17-30% of refer cases, with profound bilateral hearing loss accounting for 13% of bilateral cases.
Conclusions:
- Regional Newborn Hearing Screening programs are valuable and cost-effective for early detection.
- Centralizing data systems and control is crucial for enhancing program efficiency and effectiveness.
- Successful implementation relies on robust healthcare policies, tracking systems, and public awareness initiatives.
Background:
Hearing loss, occurring in 1-3/1,000 newborns in the well-babies population, is one of the most common congenital diseases, and hearing screening at birth still represents the only means for its early detection. Since 2011 the Emilia Romagna Regional Health Agency has recommended Newborn Hearing Screening for all babies at its birth points and for newborns moving to the region. The aims of this study are to analyze the results of this regional-based Newborn Hearing Screening program and to discuss the impact of the legislative endorsement on the organization.
Material And Methods:
This is an observational retrospective chart study. The recordings of well-babies and babies at Neonatal Intensive Care Units were collected during the period from January 1st 2015 to December 31st 2020. The following data were included: Newborn Hearing Screening coverage, percentage of refer at otoacoustic emissions, prevalence and entity of hearing loss, unilateral/bilateral rate, presence of audiological risk factors.
Results:
More than 99% of a total of 198,396 newborns underwent the Newborn Hearing Screening test during the period January 1st 2015 to December 31st 2020, with a coverage ranging between 99.6% and 99.9%. Overall, the percentage of confirmed hearing loss cases was about 17-30 % of refer cases, 745 children received a diagnosis of hearing loss (prevalence 3.7/1,000). Considering profound hearing loss cases, these represent 13% of bilateral hearing loss.
Conclusion:
A regional-based Newborn Hearing Screening program is valuable and cost-effective. In our experience, the centralization of the data system and of the data control is crucial in order to implement its efficiency and effectiveness. Healthcare policies, tracking systems and public awareness are decisive for a successful programme implementation.
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