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Updated: Jul 8, 2025
Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
Published on: March 24, 2023
Cochlear implantation compliance among minorities at high risk for hearing impairment following universal newborn
Oren Ziv1,2, Mattan Danovitch3,4, Daniel M Kaplan3,4
1Department of Otolaryngology-Head and Neck Surgery, Soroka University Medical Center, POB 151, Beer-Sheva, Israel. orenziv11@gmail.com.
Insights
Universal newborn hearing screening (UNHS) detects hearing impairment (HI) early. Children from consanguineous backgrounds show lower cochlear implant compliance, highlighting the need for improved family education and support.
Area of Science:
- Genetics and Audiology
- Public Health
- Pediatrics
Background:
- Universal newborn hearing screening (UNHS) is crucial for early detection of hearing impairment (HI).
- Consanguineous marriage is a cultural practice that can increase the risk of genetic conditions, including HI.
- Understanding the impact of cultural background on HI diagnosis and rehabilitation is essential for equitable healthcare.
Purpose of the Study:
- To evaluate the influence of consanguineous marriage cultural background on newborn HI detection via UNHS.
- To assess the compliance rates with hearing rehabilitation, specifically cochlear implantation (CI), in this population.
- To identify disparities in HI diagnosis and treatment outcomes based on cultural background.
Main Methods:
- A retrospective cohort study comparing children from consanguineous backgrounds with a control group.
- Included neonates diagnosed with HI after failing UNHS (oto-acoustic emission and auditory brainstem response).
- Data analyzed included epidemiological, audiological, and pregnancy-related factors, and risk factors for congenital HI.
Main Results:
- Family history of HI was more prevalent in the study group (children from consanguineous backgrounds).
- The study group showed significantly lower compliance rates for cochlear implantation (CI) and received CI at a later age.
- Bilateral CI compliance was substantially lower in the study group when recommended (48.9% vs. 94.1%).
Conclusions:
- UNHS effectively detects HI in at-risk minority populations, but compliance with cochlear implantation remains a challenge.
- Enhanced family education on early detection and HI risks is vital to improve CI compliance.
- Healthcare providers must prioritize improved communication and targeted health promotion programs for culturally diverse families.
Introduction:
The universal newborn hearing screening (UNHS) allows for early detection of hearing impairment (HI). The goal of this current study was to evaluate the impact of cultural background involving consanguineous marriage on newborn HI diagnosed using UNHS, and compliance with hearing rehabilitation.
Materials And Methods:
This is a retrospective cohort study that included all children born at a single tertiary medical center between 2011 and 2017 who did not pass the UNHS (oto-acoustic emission and auditory brainstem response), and were diagnosed with HI. The study group included children from consanguineous marriage cultural background which were compared to a control group-all other children. Data were retrieved from the computerized medical charts and included epidemiological, audiological, and pregnancy/delivery-related data, and known risk factors for congenital HI.
Results:
A total of 238 (196 study and 42 control) neonates were diagnosed with HI. Family history of HI was significantly more prevalent in the study group in mild-severe and profound HI subgroups (p = 0.03 and 0.01, respectively). Study group demonstrated lower rates of cochlear implantation (CI) compliance (p = 0.079), performed at a significantly older age (23 months (IQR 17-36.5) vs. 16 (IQR 12-26) months, p = 0.021). When recommended, bilateral CI compliance was significantly lower in the study group (94.1 vs.48.9%, p < 0.001).
Conclusion:
UNHS allows for early HI detection among minority populations at higher risk for CI, yet compliance rates remain lower compared with control. Familiarity of families with the importance of early detection and HI risk may result in higher compliance rates for cochlear implantation. Health providers should aim to improve education and communication with this unique group of patients and consider health promotion programs.
