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Lan H, Liu M, Huang C, Ren J, Huang Y, Jiang F, Lai D. Evaluation of the current situation and quality of neonatal hearing screening from hearing screening practitioners' perspective: a cross-sectional study. J Matern Fetal Neonatal Med 2024; 37:2317412. [PMID: 38369473 DOI: 10.1080/14767058.2024.2317412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 02/06/2024] [Indexed: 02/20/2024]
Abstract
BACKGROUND In recent years, neonatal hearing screening (NHS) has gained rapid traction in both developed and developing nations. However, the efficacy of these efforts depends on comprehensive standardization across all screening facets. This study aimed to assess the status and quality of NHS by investigating the knowledge, attitudes, beliefs, and practices of hearing screening practitioners regarding NHS. METHODS A cross-sectional survey was conducted, and an online questionnaire based on the knowledge-attitude/belief (A/B)-practice model was distributed to all NHS practitioners in Luzhou, western China. Valid questionnaires were examined and uniformly graded. RESULTS A total of 63 valid questionnaires were collected. The practitioners were mainly female (96.83%), with nursing backgrounds (63.49%), and undergraduate degrees (66.67%). Most had ≤5 years of experience (74.60%) and had junior/intermediate titles (93.65%). The NHS within the Luzhou area started in 2006 with provincial institutions, expanding to 42 institutions by 2022. Statistically significant correlations were observed between the A/B score and the conducting years of each NHS institution (p < .05) as well as between the Knowledge (K) and Practice (P) scores (p < .01). No significant correlation was found between the K score, P score, A/B score, and working years of practitioners (p > .05), or in the total score of NHS institutions at different levels or in different counties by one-way ANOVA (p > .05). CONCLUSIONS It has been 17 years since the first medical institution in Luzhou launched NHS, and the overall performance of practitioners from different institutions has been consistent in terms of their knowledge, attitudes, or level of practice. However, there is room for further improvement in both the professional development of individuals and aspects related to work, such as health education and long-term follow-up.
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Affiliation(s)
- Hongli Lan
- Department of Otolaryngology Head and Neck Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Maojie Liu
- Department of Otolaryngology Head and Neck Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Chao Huang
- Department of Otolaryngology Head and Neck Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Jing Ren
- Department of Otolaryngology Head and Neck Surgery, The People's Hospital of Leshan, Leshan, China
| | - Yu Huang
- Department of Otolaryngology Head and Neck Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Fan Jiang
- Department of Otolaryngology Head and Neck Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Dan Lai
- Department of Otolaryngology Head and Neck Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China
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Kim S, Choi S, Chang J, Lee HY, Park SK, Choi KY. Impact of national health insurance and socioeconomic disparities on newborn hearing screening performance in South Korea: A nationwide population-based evaluation. Int J Pediatr Otorhinolaryngol 2024; 181:111969. [PMID: 38744004 DOI: 10.1016/j.ijporl.2024.111969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 04/28/2024] [Accepted: 05/05/2024] [Indexed: 05/16/2024]
Abstract
OBJECTIVES This study aimed to assess the impact of national health insurance coverage on newborn hearing screening (NHS) outcomes by analyzing hearing questionnaires from the National Infant Health Check-up Program (NIHCP) in South Korea. METHODS This study evaluated the performance and referral rates of NHS using nationwide data from 814,875 infants enrolled in the 4-month NIHCP from January 2017 to December 2019. This period encompasses the periods before and after the National Health Insurance in South Korea began covering NHS expenses in October 2018. The study also investigated household income levels to determine their relationship with participation in the NIHCP and NHS outcomes. RESULTS The performance of NIHCP increased year-on-year, with NHS performance rates increasing from 88.5 % in 2017 to 91.5 % in 2019. Analysis by household income level revealed that the medical benefit recipients' group had the lowest NHS performance rate of 81.9 % in 2019, whereas that of the higher income level group exceeded 90 %. The NHS referral rate remained consistent at 0.9 % nationally during the study period. CONCLUSION The inclusion of NHS in national insurance coverage positively influenced its performance rates across South Korea. Nevertheless, the data indicate the need for more focused and customized support for low-income families to enhance early hearing detection and interventions in newborns and infants.
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Affiliation(s)
- Sojeong Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Ewha Womans University, Seoul, South Korea
| | - Sun Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - Jiwon Chang
- Department of Otorhinolaryngology-Head and Neck Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - Ho Yun Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Ewha Womans University, Seoul, South Korea
| | | | - Kyu Young Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea.
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Choe G, Park SK, Kim BJ. Hearing loss in neonates and infants. Clin Exp Pediatr 2023; 66:369-376. [PMID: 36634668 PMCID: PMC10475863 DOI: 10.3345/cep.2022.01011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 12/12/2022] [Accepted: 12/19/2022] [Indexed: 01/10/2023] Open
Abstract
Hearing in neonates and infants is crucial for their development of language and communication skills. Unless hearing loss is appropriately managed early, it can cause a significant socioeconomic burden considering its detrimental impact on the child's development and its common nature. It is also the most common congenital sensory deficit, with an approximate incidence of 1.5 per 1,000 newborns. Its etiologies are heterogeneous: genetic causes are reportedly involved in up to 80% of cases, while congenital cytomegalovirus infection is the leading environmental factor contributing to congenital hearing loss. The introduction of newborn hearing screening using automated auditory brainstem response and/or automated otoacoustic emission in many developed countries has helped detect and manage hearing loss early. Current auditory rehabilitation options such as cochlear implantation implementing cutting-edge technologies can treat almost all degrees of hearing loss, emphasizing the importance of early hearing detection and intervention. Rapidly developing genetic diagnostic technologies and future cutting-edge treatment options, including gene therapy, will shed light on the future management of hearing loss in neonates and infants.
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Affiliation(s)
- Goun Choe
- Department of Otolaryngology-Head and Neck Surgery, Chungnam National University Sejong Hospital, Chungnam National University College of Medicine, Sejong, Korea
| | - Su-Kyoung Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Bong Jik Kim
- Department of Otolaryngology-Head and Neck Surgery, Chungnam National University Sejong Hospital, Chungnam National University College of Medicine, Sejong, Korea
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Kim Y, Kim YM, Kim DR, Kim HG, Sung JH, Choi SJ, Oh SY, Kim YJ, Chang YS, Kim D, Kim JS, Moon IJ, Roh CR. The Multifaceted Clinical Characteristics of Congenital Cytomegalovirus Infection: From Pregnancy to Long-Term Outcomes. J Korean Med Sci 2023; 38:e249. [PMID: 37582499 PMCID: PMC10427218 DOI: 10.3346/jkms.2023.38.e249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 05/17/2023] [Indexed: 08/17/2023] Open
Abstract
BACKGROUND The aim of this study was to capture multifaceted clinical characteristics of congenital cytomegalovirus (CMV) infection from diagnosis to treatment using a multidisciplinary approach including obstetrics, pediatrics, pathology, and otorhinolaryngology-head and neck surgery. METHODS This is a retrospective study including 30 consecutive cases of congenital CMV infection that were diagnosed at a single tertiary hospital located in Seoul, Korea from January 2009 to December 2020. Congenital CMV infection was defined as a positive result by polymerase chain reaction from urine, saliva or cerebrospinal fluid or positive CMV IgM from neonatal blood sampled within 3 weeks after birth. All cases were analyzed with respect to whole clinical characteristics from diagnosis to treatment of congenital CMV by a multidisciplinary approach including prenatal sonographic findings, maternal immune status regarding CMV infection, detailed placental pathology, neonatal clinical manifestation, auditory brainstem response test, and antiviral treatment (ganciclovir or valganciclovir). Long-term outcomes including developmental delay and hearing loss were also investigated. RESULTS The total number of births during the study period in our institution was 19,385, with the prevalence of congenital infection estimated to be 0.15%. Among 30 cases of congenital CMV, the median gestational age at delivery was 32.2 weeks [range, 22.6-40.0] and 66.7% of these infants were delivered preterm at less than 37 weeks. Suspected fetal growth restriction was the most common prenatal ultrasound finding (50%) followed by ventriculomegaly (17.9%) and abnormal placenta (17.9%), defined as thick placenta with calcification. No abnormal findings on ultrasound examination were observed in one-third of births. Maternal CMV serology tests were conducted in only 8 cases, and one case each of positive and equivocal IgM were found. The most common placental pathologic findings were chronic villitis (66.7%) and calcification (63.0%), whereas viral inclusions were identified in only 22.2%. The most common neonatal manifestations were jaundice (58.6%) followed by elevation of aspartate aminotransferase (55.2%) and thrombocytopenia (51.7%). After excluding cases for which long-term outcomes were unavailable due to death (n = 4) or subsequent follow up loss (n = 3), developmental delay was confirmed in 43.5% of infants (10/23), and hearing loss was confirmed in 42.9% (9/21) during the follow-up period. In our cohort, 56.7% (17/30) of neonates were treated for congenital CMV with ganciclovir or valganciclovir. CONCLUSION Our data show that prenatal findings including maternal serologic tests and ultrasound have limited ability to detect congenital CMV in Korea. Given that CMV is associated with high rates of developmental delay and hearing loss in infants, there is an urgent need to develop specific strategies for the definite diagnosis of congenital CMV infection during the perinatal period by a multidisciplinary approach to decrease the risks of neurologic impairment and hearing loss through early antiviral treatment.
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Affiliation(s)
- Yejin Kim
- Department of Obstetrics and Gynecology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
| | - Yoo-Min Kim
- Department of Obstetrics and Gynecology, Chung-Ang University College of Medicine, Seoul, Korea
| | - Doo Ri Kim
- Department of Pediatrics, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
| | - Han Gyeol Kim
- Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Ji-Hee Sung
- Department of Obstetrics and Gynecology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
| | - Suk-Joo Choi
- Department of Obstetrics and Gynecology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
| | - Soo-Young Oh
- Department of Obstetrics and Gynecology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea.
| | - Yae-Jean Kim
- Department of Pediatrics, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea.
| | - Yun Sil Chang
- Department of Pediatrics, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
| | - Dongsub Kim
- Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jung-Sun Kim
- Department of Pathology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
| | - Il Joon Moon
- Department of Otorhinolaryngology-Head and Neck Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
| | - Cheong-Rae Roh
- Department of Obstetrics and Gynecology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
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Choi SR, Kim KR, Son S, Kim DS, Chang YS, Cho EY, Chang MY, Kim YK, Jo DS, Kim JK, Cho HK, Park SE, Park KH, Kim HM, Lee BK, Kim YJ. The Prevalence of Symptomatic Congenital Cytomegalovirus Disease in Korea; A 15-Year Multicenter Study and Analysis of Big Data From National Health Insurance System. J Pediatric Infect Dis Soc 2023; 12:104-108. [PMID: 36399091 DOI: 10.1093/jpids/piac118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 11/17/2022] [Indexed: 11/19/2022]
Abstract
The birth prevalence of symptomatic congenital cytomegalovirus (cCMV) disease among live birth in Korea from a multicenter study was 0.06% during 2001-2015 with increasing frequency. The administrative prevalence of cCMV infection by big-data analysis from the national health insurance system was 0.01% and the average healthcare cost was US$2010 per person.
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Affiliation(s)
- Sae Rom Choi
- Department of Pediatrics, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
| | - Kyung-Ran Kim
- Department of Pediatrics, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
| | - Sohee Son
- Department of Pediatrics, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
| | - Dong Sub Kim
- Department of Pediatrics, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea.,Department of Pediatrics, Kyungpook National University Children's Hospital, Daegu, Korea
| | - Yun Sil Chang
- Department of Pediatrics, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
| | - Eun Young Cho
- Department of Pediatrics, Chungnam National University School of Medicine, Daejeon, Korea
| | - Mea-Young Chang
- Department of Pediatrics, Chungnam National University School of Medicine, Daejeon, Korea
| | - Yun-Kyung Kim
- Department of Pediatrics, Korea University Ansan Hospital, Ansan, Korea
| | - Dae Sun Jo
- Department of Pediatrics, Jeonbuk National University Children's Hospital, Jeonju, Korea
| | - Jin Kyu Kim
- Department of Pediatrics, Jeonbuk National University Children's Hospital, Jeonju, Korea
| | - Hye-Kyung Cho
- Department of Pediatrics, Gachon University Gil Medical Center, Incheon, Korea
| | - Su Eun Park
- Department of Pediatrics, Pusan National University Children's Hospital, Yangsan, Korea
| | - Kyung Hee Park
- Department of Pediatrics, Pusan National University Hospital, Busan, Korea
| | - Hwang Min Kim
- Department of Pediatrics, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Byung-Kook Lee
- Department of Pediatrics, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Yae-Jean Kim
- Department of Pediatrics, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea.,Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea
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Botelho JBL, de Carvalho DM, dos Santos-Melo GZ, Cardoso J, do Nascimento SM, de Figueiredo WLD, Lacerda LA, Nogueira KH. Follow-up of children diagnosed with deafness in a neonatal hearing screening program in Manaus. Rev Saude Publica 2022; 56:120. [PMID: 36629711 PMCID: PMC9749742 DOI: 10.11606/s1518-8787.2022056004207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 03/18/2022] [Indexed: 12/28/2022] Open
Abstract
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.
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Affiliation(s)
- João Bosco Lopes Botelho
- Universidade do Estado do AmazonasFaculdade de MedicinaDepartamento de MedicinaManausAmazonasBrasil Universidade do Estado do Amazonas. Faculdade de Medicina. Departamento de Medicina. Manaus, Amazonas, Brasil
| | - Diego Monteiro de Carvalho
- Universidade do Estado do AmazonasFaculdade de MedicinaDepartamento de MedicinaManausAmazonasBrasil Universidade do Estado do Amazonas. Faculdade de Medicina. Departamento de Medicina. Manaus, Amazonas, Brasil
| | - Giane Zupellari dos Santos-Melo
- Universidade do Estado do AmazonasFaculdade de MedicinaDepartamento de MedicinaManausAmazonasBrasil Universidade do Estado do Amazonas. Faculdade de Medicina. Departamento de Medicina. Manaus, Amazonas, Brasil
| | - José Cardoso
- Universidade do Estado do AmazonasFaculdade de MedicinaDepartamento de MedicinaManausAmazonasBrasil Universidade do Estado do Amazonas. Faculdade de Medicina. Departamento de Medicina. Manaus, Amazonas, Brasil
| | - Samuel Machado do Nascimento
- Centro Universitário FametroFaculdade de MedicinaDepartamento de MedicinaManausAmazonasBrasil Centro Universitário Fametro. Faculdade de Medicina. Departamento de Medicina. Manaus, Amazonas, Brasil
| | - Wenberger Lanza Daniel de Figueiredo
- Universidade Nilton LinsFaculdade de MedicinaDepartamento de MedicinaManausAmazonasBrasil Universidade Nilton Lins. Faculdade de Medicina. Departamento de Medicina. Manaus, Amazonas, Brasil
| | - Larissa Abreu Lacerda
- Universidade do Estado do AmazonasFaculdade de MedicinaDepartamento de MedicinaManausAmazonasBrasil Universidade do Estado do Amazonas. Faculdade de Medicina. Departamento de Medicina. Manaus, Amazonas, Brasil
| | - Kristian Holanda Nogueira
- Universidade do Estado do AmazonasFaculdade de MedicinaDepartamento de MedicinaManausAmazonasBrasil Universidade do Estado do Amazonas. Faculdade de Medicina. Departamento de Medicina. Manaus, Amazonas, Brasil
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Choi KY, Park SK, Choi S, Chang J. Analysis of Newborn Hearing Screening Results in South Korea after National Health Insurance Coverage: A Nationwide Population-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15052. [PMID: 36429776 PMCID: PMC9690745 DOI: 10.3390/ijerph192215052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/03/2022] [Accepted: 11/15/2022] [Indexed: 06/16/2023]
Abstract
Newborn hearing screening (NHS) has been covered by national health insurance since October 2018 in Korea. However, the results of the NHS are not reported due to the absence of a follow-up tracking system. This study analyzed the status and the predicted referral rates of NHS after the Korean national health insurance coverage by analyzing the National Health Insurance Service database in 2019 and 2020. The NHS coverage was 91.7% of total birth in 2019 and 92.1% in 2020. The predicted referral rate of NHS calculated by the duplicated NHS cases was 1.05% in 2019 and 0.99% in 2020. However, another predicted referral rate calculated by the number of diagnostic auditory brainstem responses (ABRs) performed was 1.44% in 2019 and 1.43% in 2020. The first NHS was performed within one day of birth for 96.5% of the babies and within three days of birth for 97%. However, diagnostic ABR was adequately performed within three months of birth for only 4.3%, while 82.3% performed the test after six months which delays appropriate intervention for hearing loss. National support such as national coordinators, follow-up tracking, and data management systems are needed for early hearing detection and intervention of newborns and infants in Korea.
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Affiliation(s)
- Kyu Young Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Kangnam Sacred Heart Hospital, Hallym University, Seoul 07441, Republic of Korea
| | - Su-Kyoung Park
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Kangnam Sacred Heart Hospital, Hallym University, Seoul 07441, Republic of Korea
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Mackey AR, Bussé AML, Del Vecchio V, Mäki-Torkko E, Uhlén IM. Protocol and programme factors associated with referral and loss to follow-up from newborn hearing screening: a systematic review. BMC Pediatr 2022; 22:473. [PMID: 35932008 PMCID: PMC9354382 DOI: 10.1186/s12887-022-03218-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 03/14/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND An effective newborn hearing screening programme has low referral rate and low loss to follow-up (LTFU) rate after referral from initial screening. This systematic review identified studies evaluating the effect of protocol and programme factors on these two outcomes, including the screening method used and the infant group. METHODS Five databases were searched (latest: April 2021). Included studies reported original data from newborn hearing screening and described the target outcomes against a protocol or programme level factor. Studies were excluded if results were only available for one risk condition, for each ear, or for < 100 infants, or if methodological bias was observed. Included studies were evaluated for quality across three domains: sample, screening and outcome, using modified criteria from the Ottawa-Newcastle and QUADAS-2 scales. Findings from the included studies were synthesised in tables, figures and text. RESULTS Fifty-eight studies reported on referral rate, 8 on LTFU rate, and 35 on both. Only 15 studies defined LTFU. Substantial diversity in referral and LTFU rate was observed across studies. Twelve of fourteen studies that evaluated screening method showed lower referral rates with aABR compared to TEOAE for well babies (WB). Rescreening before hospital discharge and screening after 3 days of age reduced referral rates. Studies investigating LTFU reported lower rates for programmes that had audiologist involvement, did not require fees for step 2, were embedded in a larger regional or national programme, and scheduled follow-up in a location accessible to the families. In programmes with low overall LTFU, higher LTFU was observed for infants from the NICU compared to WB. CONCLUSION Although poor reporting and exclusion of non-English articles may limit the generalisability from this review, key influential factors for referral and LTFU rates were identified. Including aABR in WB screening can effectively reduce referral rates, but it is not the only solution. The reported referral and LTFU rates vary largely across studies, implying the contribution of several parameters identified in this review and the context in which the programme is performed. Extra attention should be paid to infants with higher risk for hearing impairment to ensure their return to follow-up.
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Affiliation(s)
- Allison R Mackey
- Karolinska Institutet, Department of Clinical Science Intervention and Technology, Division of Ear, Nose and Throat Diseases, Karolinska University Hospital, Huddinge, 141 86, Stockholm, Sweden.
| | - Andrea M L Bussé
- Department of Otorhinolaryngology and Head and Neck Surgery and Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Valeria Del Vecchio
- Department of Neuroscience, University of Padua, Bologna, Italy
- Unit of Audiology, Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Elina Mäki-Torkko
- Audiological Research Centre, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Inger M Uhlén
- Karolinska Institutet, Department of Clinical Science Intervention and Technology, Division of Ear, Nose and Throat Diseases, Karolinska University Hospital, Huddinge, 141 86, Stockholm, Sweden
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9
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Retinopathy of Prematurity and Hearing Impairment in Infants Born with Very-Low-Birth-Weight: Analysis of a Korean Neonatal Network Database. J Clin Med 2021; 10:jcm10204781. [PMID: 34682904 PMCID: PMC8537798 DOI: 10.3390/jcm10204781] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 10/14/2021] [Accepted: 10/16/2021] [Indexed: 11/17/2022] Open
Abstract
Background: To investigate hearing impairment and its association with retinopathy of prematurity (ROP) among children born with very low birth weight (VLBW, birth weight < 1500 g). Methods: This prospective registry study included 7940 VLBW infants who underwent both ophthalmic (ROP) and hearing screening at the 70 participating centers of the Korean Neonatal Network. Hearing screening was performed using auditory brainstem response and/or automated otoacoustic emission testing. Hearing impairment, defined as a unilateral or bilateral hearing threshold of ≥40 dB on the auditory brainstem response threshold (ABR-T) test, was evaluated and compared between children with and without ROP at the corrected ages of 18 months and 3 years. Results: The frequency of infants who did not undergo hearing screening at near-term ages was higher in the ROP group than in the no-ROP group (18.2% vs. 12.0%, p < 0.001), and the prevalence of hearing impairment at 18 months was higher in the ROP group than in the no-ROP group (3.5% vs. 2.2%, p = 0.043). The prevalence of deafness was higher in children with ROP than those without ROP (0.4% vs. 0.1%, p = 0.049). There were significant differences in hearing impairment among the stages of ROP (p < 0.001). However, multivariate analyses and propensity score matching showed no significant association between ROP and hearing impairment at 18 months and 3 years after adjusting for prematurity-related variables (all p > 0.05). Conclusions: Among infants born with VLBW, hearing impairment was more common in those with ROP than in those without ROP at 18 months of age. However, there was no significant independent association between hearing impairment and ROP.
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10
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Seo G, Choi HG, Jang S, Choi S, Lee SR, Park SK. Analysis of the Referral Rates of Newborn Hearing Screening Test According to Childbirth Delivery Methods in Neonatal Care Units. J Clin Med 2021; 10:jcm10132923. [PMID: 34210006 PMCID: PMC8268358 DOI: 10.3390/jcm10132923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 06/13/2021] [Accepted: 06/27/2021] [Indexed: 12/02/2022] Open
Abstract
It is known that neonates born by cesarean delivery (CD) may have higher referral rates than those born by vaginal delivery (VD) for newborn hearing screening (NHS). False-positive NHS results can increase costs and parental anxiety. This study analyzed the differences in NHS referral rates according to delivery methods in Level I, II, and III neonatal care units. A retrospective chart review was done for 2322 infants (4644 ears) with delivery records who underwent NHS between 2004 and 2017. The first NHS was performed immediately before discharge when the infant was in good condition via the automated auditory brainstem response (AABR) or automated otoacoustic emissions (AOAE). There were 98 neonates (196 ears) who underwent both AABR and AOAE simultaneously as the first NHS, 30 of which failed. We used a total of 4810 ears in this analysis. Of all enrolled ears, 2075 ears were of neonates born by CD, and 2735 ears were of neonates born by VD. A total of 2460 ears were from patients in Level III neonatal intensive care units (NICU) and 2350 ears were from Level I and II neonatal care units. The overall referral rate was higher in infants born via CD (4.5%) than VD (3.2%). In Level I and II neonatal intensive care units, the referral rate was significantly higher in those born via CD (3.0%) than via VD (1.4%). Further, based on the screening method, AABR (75.8%) was more frequently used than AOAE (24.2%), thereby revealing AABR’s higher referral rate in CD (2.9%) than in VD (1.2%). The referral rate of infants who underwent the NHS within three days of birth was higher in the CD group (3.0%) than in the VD group (1.3%). There was no significant difference in the referral rate depending on the delivery method when infants were hospitalized for more than four days or hospitalized in the NICU. The referral rate according to the delivery methods was significantly higher when the NHS test was performed for healthy newborns in the Level I and II neonatal care units born by CD within 72 h using AABR. Therefore, we recommend that the hearing screening test for newborns delivered by cesarean section be performed after 72 h of age. The results of this study may reduce the false-positive NHS results, unnecessary further tests, and parental anxiety.
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Affiliation(s)
- Ganghyeon Seo
- Department of Otorhinolaryngology-Head and Neck Surgery, Kangnam Sacred Heart Hospital, Hallym University, College of Medicine, 1, Singil-ro, Yeongdeungpo-gu, Seoul 07441, Korea; (G.S.); (S.J.); (S.C.)
| | - Hyo Geun Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Hallym Sacred Heart Hospital, Hallym University, College of Medicine, 22, Gwanpyeong-ro 170beon-gil, Dongan-gu, Anyang 14068, Korea;
| | - Sookyung Jang
- Department of Otorhinolaryngology-Head and Neck Surgery, Kangnam Sacred Heart Hospital, Hallym University, College of Medicine, 1, Singil-ro, Yeongdeungpo-gu, Seoul 07441, Korea; (G.S.); (S.J.); (S.C.)
| | - Sun Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Kangnam Sacred Heart Hospital, Hallym University, College of Medicine, 1, Singil-ro, Yeongdeungpo-gu, Seoul 07441, Korea; (G.S.); (S.J.); (S.C.)
| | - Sa Ra Lee
- Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan, College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea
- Correspondence: (S.R.L.); (S.-K.P.); Tel.: +82-2-3010-3648 (S.R.L.); +82-2-829-5217 (S.-K.P.); Fax: +82-2-3010-3630 (S.R.L.); +82-2-842-5217 (S.-K.P.)
| | - Su-Kyoung Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Kangnam Sacred Heart Hospital, Hallym University, College of Medicine, 1, Singil-ro, Yeongdeungpo-gu, Seoul 07441, Korea; (G.S.); (S.J.); (S.C.)
- Correspondence: (S.R.L.); (S.-K.P.); Tel.: +82-2-3010-3648 (S.R.L.); +82-2-829-5217 (S.-K.P.); Fax: +82-2-3010-3630 (S.R.L.); +82-2-842-5217 (S.-K.P.)
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