COVID Effects on Adherence to Joint Committee on Infant Hearing Newborn Screening Recommendations
Hengameh K Behzadpour1, Jennifer Chappetto2, Tracey Ambrose3
1Division of Otolaryngology, Children's National Hospital, Washington, DC, USA.
Insights
Infants failing newborn hearing screenings (NBHS) have high lost to follow-up (LTF) rates, with factors like male gender and lower income increasing risk. The COVID-19 pandemic saw a slight decrease in LTF, but challenges remain for timely diagnosis.
Area of Science:
- Audiology
- Public Health
- Pediatrics
Background:
- Newborn hearing screenings (NBHS) are crucial for early detection of hearing loss in infants.
- Lost to follow-up (LTF) after failed NBHS delays diagnosis and intervention, impacting developmental outcomes.
- The COVID-19 pandemic may have influenced adherence to follow-up protocols.
Purpose of the Study:
- To assess the LTF rate for infants who did not pass NBHS in Washington, DC.
- To compare LTF rates before and during the COVID-19 pandemic.
- To identify demographic and clinical factors associated with LTF.
Main Methods:
- A cohort study analyzed NBHS data from March 2019 to March 2021 using web-based reports.
- Multivariate and univariate regression analyses were employed to identify significant factors.
- The study included 15,661 infants, with a focus on the 830 who failed initial screening.
Main Results:
- The overall LTF rate was 90.7% pre-COVID and 83% during the pandemic.
- Of infants failing initial screening, 46.7% did not pass follow-up, and 88.1% lacked diagnostic Auditory Brainstem Response assessment.
- Factors associated with LTF included male gender, income <$100K, and residing in specific wards.
Conclusions:
- High LTF rates persist despite NBHS improvements, impacting timely audiological care.
- Demographic factors significantly influence an infant's likelihood of completing follow-up.
- Findings will inform strategies to reduce LTF and improve early intervention for hearing loss.
Objective:
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.
Study Design:
Cohort study analyzing variables potentially impacting LTF.
Setting:
Web-based analysis of DC Oz e-Screener Plus for NBHS reports.
Methods:
Multivariate and univariate regression analyses were used to identify significant demographic and clinical factors from March 2019 to March 2021.
Results:
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.
Conclusion:
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.
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