COVID Effects on Adherence to Joint Committee on Infant Hearing Newborn Screening Recommendations

Despite significant improvements in universal newborn hearing screenings (NBHS), infants are still lost to follow-up (LTF) after failed screening, delaying timely diagnosis and intervention. The challenges during the COVID-19 pandemic and its response likely exacerbated timely adherence to early diagnosis and intervention. This study aimed to assess the LTF rate for infants who did not pass their NBHS within Washington, DC and compare the LFT before and during the pandemic.

Cohort study analyzing variables potentially impacting LTF.

Web-based analysis of DC Oz e-Screener Plus for NBHS reports.

Multivariate and univariate regression analyses were used to identify significant demographic and clinical factors from March 2019 to March 2021.

Of the 15,661 born during the period analyzed, 830 (5.3%) infants did not pass their initial hearing screening: 406 (48.9%) infants in the pre-COVID group and 424 (51.1%) infants in the COVID group. Of those infants failing their initial screening, 388 (46.7%) did not pass a follow-up outpatient screening. Of these, 342 (88.1%) had no record of receiving a Diagnostic Auditory Brainstem Response assessment. The overall LTF rate in the pre-COVID group was 90.7% compared to 83% in the COVID group. Multivariate analyses showed that male gender (odds ratio [OR] = 1.3), income <100 K (OR = 1.9), wards 7 and 8 (OR = 1.9), and pre-COVID group (OR = 0.7) were statistically associated with LTF.

There are many factors impacting LTF rates and future follow-up when using the protocols recommended by the Joint Committee on Infant Hearing. This study will be the basis for implementing planned improvement strategies for reducing LTF rates.