Assessment of the feasibility and coverage of a modified universal hearing screening protocol for use with newborn babies of migrant workers in Beijing

BMC Pediatrics

Demin Han¹  Luo Zhang¹  Lihui Huang¹  Zhenghua Cai¹  Yong Zhen¹  Shichun Peng¹  Bo Liu¹  Hui En¹  Xiaohua Cheng¹  Beier Qi¹ 

[1] Key Laboratory of Otolaryngology Head and Neck Surgery (Ministry of Education), Beijing Institute of Otolaryngology, 17 HouGouHuTong, DongCheng District, Beijing, 100005, China

关键词: Universal newborn hearing screening (UNHS);    Otoacoustic emissions (OAE);    Newborn babies;    Migrant people;    Auditory brainstem response (ABR);   

Others  :  1144673
DOI  :  10.1186/1471-2431-13-116

 received in 2013-01-01, accepted in 2013-08-07,  发布年份 2013

【 摘 要 】

Background

Although migrant workers account for the majority of newborns in Beijing, their children are less likely to undergo appropriate universal newborn hearing screening/rescreening (UNHS) than newborns of local non-migrant residents. We hypothesised that this was at least in part due to the inadequacy of the UNHS protocol currently employed for newborn babies, and therefore aimed to modify the protocol to specifically reflect the needs of the migrant population.

Methods

A total of 10,983 healthy babies born to migrant mothers between January 2007 and December 2009 at a Beijing public hospital were investigated for hearing abnormalities according to a modified UNHS protocol. This incorporated two additional/optional otoacoustic emissions (OAE) tests at 24–48 hours and 2 months after birth. Infants not passing a screening test were referred to the next test, until any hearing loss was confirmed by the auditory brainstem response (ABR) test.

Results

A total of 98.91% (10983/11104) of all newborn children underwent the initial OAE test, of which 27.22% (2990/10983) failed the test. 1712 of the failed babies underwent the second inpatient OAE test, with739 failing again; thus significantly decreasing the overall positive rate for abnormal hearing from 27.22% to 18.36% ([2990–973 /10983)]; p = 0). Overall, 1147(56.87%) babies underwent the outpatient OAE test again after1-month, of whom 228 failed and were referred for the second outpatient OAE test (i.e. 2.08% (228/10983) referral rate at 1month of age). 141 of these infants underwent the referral test, of whom 103 (73.05%) tested positive again and were referred for a final ABR test for hearing loss (i.e. final referral rate of 1.73% ([228-38/10983] at 2 months of age). Only 54 infants attended the ABR test and 35 (0.32% of the original cohort tested) were diagnosed with abnormal hearing.

Conclusions

Our study shows that it is feasible and practical to achieve high coverage rates for screening hearing loss and decrease the referral rates in newborn babies of migrant workers, using a modification of the currently employed UNHS protocol.

【 授权许可】

   
2013 Qi et al.; licensee BioMed Central Ltd.

【 图 表 】

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【 参考文献 】

• [1]Davis A, Bamford J, Wilson I, Ramkalawan T, Forshaw M, Wright S: A critical review of the role of neonatal hearing screening in the detection of congenital hearing impairment. Health Technol Assess 1997, 1(10):1-176.
• [2]Carney AE, Moeller MP: Treatment efficacy: hearing loss in children. J Speech Lang Hear Res 1998, 41(1):S61-S84.
• [3]National Institutes of Health: Early identification of hearing impairment in infants and young children. NIH Consens Statement 1993, 11(1):1-24.
• [4]Huang L, Han D, Guo Y, Liu S, Cui X, Mo L, Qi B, Cai Z, Liu H, En H, Guo L: Audiological characteristics of infants with abnormal transient evoked otoacoustic emission and normal auditory brainstem response. Biosci Trends 2008, 2:211-215.
• [5]Sininger YS, Doyle KJ, Moore JK: The case for early identification of hearing loss in children. Auditory system development, experimental auditory deprivation, and development of speech perception and hearing. PediatrClin North Am 1999, 46:1-14.
• [6]Kennedy CR, McCann DC, Campbell MJ, Law CM, Mullee M, Petrou S, Watkin P, Worsfold S, Yuen HM, Stevenson: Language ability after early detection of permanent childhood hearing impairment. N Engl J Med 2006, 354:2131-2141.
• [7]Yoshinaga-Itano C: Universal newborn hearing screening programs and developmental outcomes. Audiol Med 2003, 1:199-206.
• [8]Moeller MP: Early intervention and language development in children who are deaf and hard of hearing. Pediatrics 2000, 106(3):1-9.
• [9]Yoshinaga-Itano C, Coulter D, Thomson V: The Colorado newborn hearing screening project: effects on speech and language development for children with hearing loss. J Perinatol 2000, 20:S132-S137.
• [10]Yoshinaga-Itano C: Levels of evidence: universal newborn hearing screening (UNHS) and early hearing detection and intervention systems (EHDI). J Commun Disord 2004, 37:451-465.
• [11]Calderon R, Naidu S: Further support of the benefits of early identification and intervention with children with hearing loss. Volta Rev 2000, 100(5):53-84.
• [12]Beijing Municipal Bureau of Health: The technical regulations of neonatal disease screening. http://www.bjhb.gov.cn/zwfwq/zcfg2_356/ webcite
• [13]Ministry of Health of the People’s Republic of China: The national neonatal congenital disease screening plan. http://www.moh.gov.cn/publicfiles/business/htmlfiles/mohbgt/s10695/200911/44716.htm webcite
• [14]Ministry of Health of the People’s Republic of China: Technical regulations of neonatal disease screening. http://www.moh.gov.cn/publicfiles/business/htmlfiles/mohfybjysqwss/s6746/200804/18192.htm webcite
• [15]Beijing Municipal Center for Disease prevention and Control: The coverage rate of UNHS in Beijing. http://zhengwu.beijing.gov.cn/tjxx/tjfx/t961435.htm webcite
• [16]Beijing Municipal Bureau of Statistics: Beijing statistical year book. 2011. http://www.bjstats.gov.cn/nj/main/2011-tjnj/content/mV35_0302.htm webcite
• [17]Orlando MS, Prieve BA: Models for universal newborn hearing screening programs, universal newborn hearing screening. New York: Thieme Medical Publishers Inc; 1998.
• [18]Gravel J, Berg A, Bradley M, Cacace A, Campbell D, Dalzell L, DeCristofaro J, Greenberg E, Gross S, Orlando M, Pinheiro J, Regan J, Spivak L, Stevens F, Prieve B: New York State universal newborn hearing screening demonstration project: effects of screening protocol on inpatient outcome measures. Ear Hear 2000, 21:31-140.
• [19]Cai ZH, Huang LH, En H, Peng SC, Zhen Y, Qi BE, Kan C, Cheng XX, Wang SH, Li JR, Hou TX: Infants hearing screening in the coastal villages of Shandong province. Chin J Otorhinolaryngol Head Neck Surg 2006, 41(2):104-106.
• [20]Year 2000 position statement: principles and guidelines for early hearing detection and intervention programs. Joint committee on infant hearing Am J Audio 2000, 9(1):9-29.
• [21]Zhang X, Ma Y, Shi L, Xing J, Huang L: The analysis of 28 043 cases of neonatal hearing screening. Beijing Medicine 2008, 30(3):159-162.
• [22]Norton SJ, Gorga MP, Widen JE, Vohr BR, Folsom RC, Sininger YS, Cone-Wesson B, Fletcher KA: Identification of neonatal hearing impairment: transient evoked otoacoustic emissions during the perinatal period. Ear Hear 2000, 21:425-442.
• [23]Lin HC, Shu MT, Chang KC, Bruna SM: A universal newborn hearing screening program in Taiwan. Int Pediatr Otorhinolaryngol 2002, 63:209-218.
• [24]Bailey HD, Bower C, Krishnaswamy J, Coates HL: Newborn hearing screening in Western Australia. Med J Aust 2002, 177:80-185.
• [25]American Academy of Pediatrics, Joint Committee on Infant Hearing: Year 2007 Position Statement: principles and guideline for early hearing detection and intervention programs. Pediatrics 2007, 120(4):898-921.
• [26]Boone RT, Bower CM, Martin PF: Failed newborn hearing screens as presentation for otitis media with effusion in the newborn population. Int J PediatrOtorhinolaryngol 2005, 69:393-397.
• [27]Huang LH, Han DM, Liu S, Mo LY, Shi L, Zhang H, Liu B, Qi BE, Zhang W, Yang YL, Tang XQ, Xing JH: Follow-up study for newborns and infants who failed hearing screening. Chin J Otorhinolaryngol Head Neck Surg 2005, 9(40):643-647.
• [28]Swanepoel D, Erahim S, Joseph A, Friedland PL: Newborn hearing screening in a South African private health care hospital. Int J PediatrOtorhinolaryngol 2007, 71:881-887.
• [29]Olusanya BO, Wirz SL, Luxon LM: Community-based infant hearing screening for early detection of permanent hearing loss in Lagos, Nigeria: a cross-sectional study. Bull World Health Organ 2008, 86(12):956-963.
• [30]Robertson CM, Tyebkhan JM, Hagler ME, Cheung PY, Peliowsky A, Etches PC: Late-onset, progressive sensorineural hearing loss after severe neonatal respiratory failure. Otol Neurotol 2002, 23:353-356.