Follow-up of children diagnosed with deafness in a neonatal hearing screening program in Manaus
João Bosco Lopes Botelho1, Diego Monteiro de Carvalho1, Giane Zupellari Dos Santos-Melo1
1Universidade do Estado do Amazonas. Faculdade de Medicina. Departamento de Medicina. Manaus, Amazonas, Brasil.
Insights
High dropout rates plague neonatal hearing screening follow-up, with neonatal intensive care unit (ICU) stays and family history of hearing loss being key risk factors for failed otoacoustic emission retests.
Area of Science:
- Pediatric Audiology
- Neonatal Screening
- Public Health
Background:
- Neonatal hearing screening identifies infants with potential hearing loss.
- Effective follow-up is crucial for timely intervention and management of childhood deafness.
Purpose of the Study:
- To evaluate the follow-up rates of children diagnosed with deafness from neonatal hearing screening.
- To identify risk factors associated with hearing loss and poor follow-up in this population.
Main Methods:
- A quantitative, cross-sectional, and retrospective study analyzed 5,305 electronic medical records from a specialized rehabilitation center.
- Statistical analysis included Pearson's chi-square test and binary logistic regression to determine odds ratios.
Main Results:
- 6.9% of 5,305 children failed otoacoustic emission retests; 72.4% of those diagnosed had sensorineural hearing loss.
- Only 21.9% completed the study, with low rates of hearing aid use (41%) and cochlear implant surgeries (18.7%).
- Family history of hearing loss and neonatal intensive care unit (ICU) stay increased the chance of failed retests by 2.6 times.
Conclusions:
- Significant dropout rates exist in neonatal hearing screening follow-up, particularly in regions like the Amazon, influenced by socioeconomic and geographic factors.
- Neonatal ICU hospitalization and family history of hearing loss are critical risk factors for abnormal otoacoustic emission retests, highlighting areas for targeted intervention.
Objective:
To evaluate the follow-up of children diagnosed with deafness in neonatal hearing screening and risk factors for hearing loss.
Methods:
Quantitative, cross-sectional, and retrospective study to evaluate factors associated with hearing loss and the follow-up of cases of children diagnosed with audiological dysfunction, by analyzing electronic medical records of 5,305 children referred to a Specialized Center in Type I Rehabilitation, from January/2016 to February/2020, in the city of Manaus, Amazonas. The statistical study used Pearson's chi-square test and binary logistic regression in which odds ratio scans were obtained with reliability intervals of 95%.
Results:
Of the 5,305 children referred for the otoacoustic emission retest, 366 (6.9%) failed the retest. Children diagnosed with sensorineural hearing loss continued in the study, totaling 265 (72.4%). Only 58 (21.9%) children continued in the study to its end, of these 39 had received hearing aids at that point; and 16 (41%) had surgical indication for cochlear implants, of which only 3 (18.7%) had undergone surgery. Among the risk factors for hearing loss, we found 2.6 times more chance of failure in the otoacoustic emissions retest in those children who had a family history of hearing loss and ICU stay.
Conclusion:
Although the screening flow reaches a large part of live births, the dropout rates during the process are high, therefore, the socioeconomic and geographic characteristics of regions such as the Amazon should be considered as relevant factors to the evasion of rehabilitation programs of these children. Hospitalization in the neonatal ICU and family history of hearing loss in the investigations could be identified as the main and most important factors for alteration of the otoacoustic emissions retests.
