Follow-up hearing screening for at-risk infants
Fendi Obuekwe1, Anthony J Tang1, Zainab A Balogun1
1University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Insights
Few infants with prolonged NICU stays completed audiology follow-up after passing newborn hearing screening. Sensorineural hearing loss was not detected on rescreen, questioning current screening effectiveness for high-risk infants.
Area of Science:
- Neonatal care
- Audiology
- Public health
Background:
- Infants with prolonged neonatal intensive care unit (NICU) stays are at higher risk for hearing loss.
- Newborn hearing screening (NBHS) aims to identify hearing impairments early.
- Adherence to audiology follow-up is crucial for timely diagnosis and intervention.
Purpose of the Study:
- To determine the rate of audiology follow-up completion by 9 months in infants with NICU stay >5 days who passed NBHS.
- To identify factors associated with audiology follow-up completion.
- To ascertain the prevalence of sensorineural hearing loss (SNHL) detected on rescreen in this high-risk population.
Main Methods:
- Retrospective chart review of infants born between July 2020 and August 2023 at a tertiary children's hospital.
- Inclusion criteria: NICU stay >5 days and passed NBHS.
- Exclusion criteria: Missed/failed NBHS, transfer, deceased, or <12 months at analysis.
Main Results:
- Only 1.8% (13/714) of eligible infants completed audiology follow-up by 9 months.
- Female sex, ototoxic exposure, and Trisomy 21 were associated with increased odds of follow-up.
- None of the infants who completed follow-up had SNHL detected on rescreen.
Conclusions:
- Adherence to recommended audiology follow-up is very low among infants with prolonged NICU stays who passed NBHS.
- Current screening strategies may not be sufficiently effective in ensuring follow-up for high-risk infants.
- Further research is needed to improve follow-up rates and ensure early detection of SNHL in this population.
Objective:
This study aims to determine the percentage of infants with neonatal intensive care unit (NICU) stay >5 days and passed newborn hearing screening (NBHS) who complete recommended audiology follow-up and who have sensorineural hearing loss (SNHL) detected on rescreen by 9 months of age.
Methods:
A chart review was conducted of patients at a tertiary children's hospital born July 2020 to August 2023. Patients with NICU stay >5 days and completed NBHS were included (n = 929). Patients who missed their NBHS, failed their NBHS, were transferred, or were deceased were excluded (n = 97). Patients who were <12 months of age at time of analysis were also excluded (n = 118).
Results:
Only 13/714 (1.8 %) presented for audiology follow-up by 9 months of age. Being female (OR: 3.51, 95 % CI: 1.07-11.5), history of ototoxic exposure (OR: 53.9, 95 % CI: 1.38-∞), and Trisomy 21 (OR: 15.5, 95 % CI: 1.45-91.8) were associated with increased odds of follow-up with audiology by 9 months of age. Of the 13 with follow-up, none had SNHL.
Conclusion:
Infants with NICU stay >5 days and passed NBHS had a low adherence to completing recommended audiology follow-up. SNHL associated with NICU stay was not detected on rescreen. Describing the prevalence of audiology follow-up completion and SNHL detected on rescreen provides further evidence regarding the effectiveness of current screening strategies.
