Department of Audiology, Whipps Cross University Hospital, London, UK.
Int J Audiol. 2012 Jul;51(7):519-28. doi: 10.3109/14992027.2012.673237.
To examine the implications of universal neonatal screening for confirming deafness in early childhood.
A cohort that had received a universal neonatal hearing screen was followed-up until school entry, and confirmation of deafness compared with that from parallel cohorts that had not received the screen.
Three 10-year cohorts were compared: a cohort of 35,668 enrolled for universal neonatal hearing screening, a historical cohort of 31,538 when neonatal screening was unavailable, and a cohort of 32,890 when targeted screening was in place.
Prevalence of deafness by school age was 3.65/1000 with a neonatal yield of 1.79/1000. The screen had been 89% sensitive to moderate and worse deafness, 79% to unilateral deafness, and 49% to mild impairments. The median age of confirmation had been reduced from 218 to 16 weeks, but for those not identified neonatally there had been no significant improvement in the age of confirmation over the previous 25 years. The yield from post-neonatal screens had been reduced from 1.8/1000 to 0.2/1000, and with a yield of 0.8/1000, reactive referral remained a more effective route to identification.
Even with UNHS in place post-neonatal routes to identification need to be maintained and improvements investigated.
探讨在儿童早期进行普遍新生儿筛查以确诊耳聋的意义。
对接受普遍新生儿听力筛查的队列进行随访，直至入学，并与未接受该筛查的平行队列进行确诊耳聋的比较。
比较了三个 10 年队列：一个 35668 名新生儿接受普遍听力筛查的队列，一个新生儿筛查不可用时的 31538 名的历史队列，以及一个目标筛查队列的 32890 名。
学龄时耳聋的患病率为 3.65/1000，新生儿检出率为 1.79/1000。该筛查对中度及更严重耳聋的敏感度为 89%，对单侧耳聋的敏感度为 79%，对轻度听力障碍的敏感度为 49%。确诊的中位年龄已从 218 周缩短至 16 周，但对于那些未能在新生儿期被发现的儿童，在过去的 25 年中，确诊年龄并没有明显改善。新生儿后筛查的检出率已从 1.8/1000 降至 0.2/1000，而反应性转诊的检出率为 0.8/1000，仍然是一种更有效的识别途径。
即使普遍开展新生儿听力筛查，也需要维持新生儿后期的识别途径，并对其进行改进。
