Kerschner Joseph E, Meurer John R, Conway Ann E, Fleischfresser Sharon, Cowell Melissa H, Seeliger Elizabeth, George Varghese
Division of Pediatric Otolaryngology, Department of Otolaryngology, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
Int J Pediatr Otorhinolaryngol. 2004 Feb;68(2):165-74. doi: 10.1016/j.ijporl.2003.10.010.
This study assessed the prevalence of newborn hearing screening in Wisconsin between 1997 and 2001, and examined factors leading to establishment of programs and influencing the outcomes of universal newborn hearing screening (UNHS). The primary goal was to identify characteristics that might be important for states, provinces or countries that have not yet implemented UNHS programs and to examine some unique components of the Wisconsin UNHS program, that may provide direction to areas both with and without programs.
The study consisted of two cross-sectional surveys administered at two separate time points (2000 and 2001). Additional data was provided by the Wisconsin Sound Beginnings Early Detection and Hearing Intervention database.
Between 1997 and 2001, the number of Wisconsin birthing hospitals with UNHS programs increased from two to 92 of a total of 103 and the percent of all Wisconsin newborns screened for hearing loss before 1-month of age increased from 10 to 90%. In 2001, 2.6% of screened newborns had an abnormal test requiring further audiologic evaluation, with a higher rate of referral in programs relying only on otoacoustic emission testing versus automatic auditory brainstem testing. As programs were being established, hospitals with greater number of deliveries more readily developed UNHS programs and hospitals with more deliveries were also significantly more likely to screen a greater percentage of delivered children once their programs were established. The Wisconsin Sound Beginnings program established a screening program for home birth infants in 2002 with a current screen rate of 79% for those midwives participating in this program.
A vast majority of Wisconsin hospitals have voluntarily implemented UNHS programs. By 2001, greater than 90% of all Wisconsin newborns were screened through a UNHS program. With education, financial support and a statewide network dedicated to UNHS it is possible to establish programs even for infants born in a setting that should be considered high-risk to miss hearing screening, such as home births and hospitals that perform relatively few numbers of deliveries per year. UNHS programs need to develop coordinated systems for linking these programs to audiologic diagnostic services and early intervention programs.
本研究评估了1997年至2001年间威斯康星州新生儿听力筛查的普及率，并考察了促使项目建立以及影响新生儿听力普遍筛查（UNHS）结果的因素。主要目标是确定对于尚未实施UNHS项目的州、省或国家可能重要的特征，并考察威斯康星州UNHS项目的一些独特组成部分，这可能为有项目和没有项目的地区提供指导。
该研究包括在两个不同时间点（2000年和2001年）进行的两项横断面调查。威斯康星州“听力起步早期检测与听力干预”数据库提供了额外数据。
1997年至2001年间，威斯康星州设有UNHS项目的分娩医院数量从2家增加到103家医院中的92家，威斯康星州所有在1月龄前接受听力损失筛查的新生儿比例从10%增加到90%。2001年，2.6%的筛查新生儿检测结果异常，需要进一步的听力评估，仅依靠耳声发射测试的项目转诊率高于自动听性脑干反应测试项目。在项目建立过程中，分娩数量较多的医院更易开展UNHS项目，且分娩数量较多的医院在项目建立后筛查已分娩儿童的比例也显著更高。威斯康星州“听力起步”项目于2002年为在家分娩的婴儿建立了筛查项目，参与该项目的助产士目前的筛查率为79%。
威斯康星州绝大多数医院已自愿实施UNHS项目。到2001年，超过90%的威斯康星州新生儿通过UNHS项目接受了筛查。通过教育、财政支持以及致力于UNHS的全州性网络，即使是在应被视为听力筛查漏筛高风险环境中出生的婴儿，如在家分娩的婴儿和每年分娩数量相对较少的医院出生的婴儿，也有可能建立筛查项目。UNHS项目需要开发协调系统，将这些项目与听力诊断服务和早期干预项目相联系。
