Holster Ingrid L, Hoeve Lambertus J, Wieringa Marian H, Willis-Lorrier Rose M S, de Gier Henriette H W
Department of Pediatric Otorhinolaryngology, Sophia Children's Hospital, Rotterdam, The Netherlands.
J Pediatr. 2009 Nov;155(5):646-50. doi: 10.1016/j.jpeds.2009.05.003. Epub 2009 Jul 19.
We evaluated the causes of hearing loss found after failed universal newborn hearing screening and compared the results with the previously used behavioral observation test (Ewing/CAPAS).
Hearing loss in neonates, born between September 1999 and October 2007 and referred to our center after failed screening, was determined by audiologic testing and physical examination.
In 340 included neonates the results of hearing tests were as follows: normal hearing 21.2%, conductive hearing loss 20.3%, and sensorineural hearing loss (SNHL) 57.9%. Children referred from the neonatal intensive care unit were more at risk of SNHL (71%) than those from the well-baby clinics (54%). Hearing aids were provided at a median age of 8 months. The positive predictive value of SNHL screening was 54% for a child from a well-baby clinic and 71% for a child from the neonatal intensive care unit.
The use of universal newborn hearing screening results in a lower proportion of infants positive because of otitis media with effusion than the previously used Ewing/CAPAS test (20% vs 59-81%). Second, screening leads to identification of hearing loss and intervention at a younger age (8 months vs 15-18 months). Third, the positive predictive value for SNHL has improved (54% vs 2%).
我们评估了新生儿听力普遍筛查未通过后发现的听力损失原因，并将结果与之前使用的行为观察测试（尤因/ CAPAS）进行比较。
对1999年9月至2007年10月出生、筛查未通过后转诊至我们中心的新生儿，通过听力测试和体格检查确定听力损失情况。
在纳入研究的340名新生儿中，听力测试结果如下：听力正常21.2%，传导性听力损失20.3%，感音神经性听力损失（SNHL）57.9%。新生儿重症监护病房转诊来的儿童发生SNHL的风险（71%）高于健康婴儿诊所转诊来的儿童（54%）。助听器佩戴的中位年龄为8个月。健康婴儿诊所儿童SNHL筛查的阳性预测值为54%，新生儿重症监护病房儿童为71%。
与之前使用的尤因/ CAPAS测试相比，新生儿听力普遍筛查导致因中耳积液呈阳性的婴儿比例更低（20%对59 - 81%）。其次，筛查可在更小年龄（8个月对15 - 18个月）发现听力损失并进行干预。第三，SNHL的阳性预测值有所提高（54%对2%）。
