Rissmann Anke, Koehn Andrea, Loderstedt Marja, Schwemmle Cornelia, Goetze Gerrit, Bartel Sylva, Plontke Stefan K, Langer Joerg, Begall Klaus, Matulat Peter, Roehl Friedrich-Wilhelm, Vorwerk Ulrich
Newborn Hearing Screening Tracking Centre, Malformation Monitoring Centre Saxony-Anhalt, Medical Faculty Otto-von-Guericke University Magdeburg, Leipziger Strasse 44, 39120 Magdeburg, Germany.
Newborn Hearing Screening Tracking Centre, Malformation Monitoring Centre Saxony-Anhalt, Medical Faculty Otto-von-Guericke University Magdeburg, Leipziger Strasse 44, 39120 Magdeburg, Germany.
Int J Pediatr Otorhinolaryngol. 2018 Apr;107:110-120. doi: 10.1016/j.ijporl.2018.01.035. Epub 2018 Jan 31.
Early diagnosis of congenital hearing loss is fundamental to minimize the negative consequences on the speech development. To lower the age at diagnosis and at intervention in hearing impaired children, not only universal newborn hearing screening (NHS) but also tracking is considered essential. The aim of the study was to evaluate the first six years after implementation of the population based newborn hearing screening program in Saxony-Anhalt, one German Federal State.
The cross-sectional cohort study consisted of three cohort samples. Overall 102,301 infants born between January 2010 and December 2015 were included. NHS protocol was developed as dual target group protocol with two sub-protocols. The screening technique included Transient Evoked Otoacoustic Emissions (TEOAE) and Automated Auditory Brainstem Response (AABR) test. Newborns were assigned to the sub-protocols according to their audiological risk factors. Additionally, to evaluate the quality of NHS and tracking (false-negative screening) we were analysing data from a cohort of hearing impaired children diagnosed up to the age of three years. We calculated quality indicators and compared them with international guidelines.
101,102 (98.8%) infants were screened. The prevalence of bilateral neonatal hearing loss was 2.32 per 1000 newborns. The median age was two days at first screening, three month at diagnostic testing, and four month at intervention onset. 2.6% infants were lost to follow-up. 56.3% had a final diagnosis of bilateral sensorineural hearing loss. The sensitivity of 0.85 (KI 95%: 0.76–0.91) and a specificity of 0.84 (KI 95%: 0.84–0.85) was calculated for the NHS program.
The analysis of benchmarks and outcomes of NHS demonstrated that the program reaches its main goal to identify the hearing impaired newborns in a timely manner.
先天性听力损失的早期诊断对于将其对言语发育的负面影响降至最低至关重要。为了降低听力受损儿童的诊断年龄和干预年龄，不仅普遍新生儿听力筛查（NHS），而且追踪也被认为是必不可少的。本研究的目的是评估德国联邦州萨克森 - 安哈尔特实施基于人群的新生儿听力筛查项目后的头六年情况。
横断面队列研究由三个队列样本组成。总共纳入了2010年1月至2015年12月出生的102301名婴儿。NHS方案被制定为具有两个子方案的双重目标群体方案。筛查技术包括瞬态诱发耳声发射（TEOAE）和自动听性脑干反应（AABR）测试。新生儿根据其听力学风险因素被分配到子方案中。此外，为了评估NHS和追踪（假阴性筛查）的质量，我们分析了一组3岁前被诊断为听力受损儿童的数据。我们计算了质量指标并将其与国际指南进行比较。
101102名（98.8%）婴儿接受了筛查。双侧新生儿听力损失的患病率为每1000名新生儿2.32例。首次筛查的中位年龄为2天，诊断测试为3个月，干预开始为4个月。2.6%的婴儿失访。56.3%最终被诊断为双侧感音神经性听力损失。NHS项目的敏感性为0.85（95%可信区间：0.76 - 0.91），特异性为0.84（95%可信区间：0.84 - 0.85）。
NHS的基准和结果分析表明，该项目达到了及时识别听力受损新生儿的主要目标。
