Several independent risk indicators for HL were found, but they could not explain all differences in prevalence rates of HL between NICUs.

The NHS in Dutch NICUs is effective. Timely identification of hearing loss is improving over time.

Objective To estimate the costs and effects of different treatment strategies with intrapartum antibiotic prophylaxis to prevent early-onset group B streptococcal (GBS) disease in the Netherlands. The treatment strategies include a risk-based strategy, a screening-based strategy, a combined screening/risk-based strategy and the current Dutch guideline. Design Cost-effectiveness analysis based on decision model. Setting Obstetric care system in the Netherlands.Population/Sample Hypothetical cohort of 200,000 neonates.Methods A decision analysis model was used to compare the costs and effects of different treatment strategies with no treatment. Baseline estimates were derived from literature and a survey among parents of children affected by GBS disease. The analysis was performed from a societal perspective, and costs and effects were discounted at a percentage of 3%. Main outcome measures Cost per quality adjusted of life-year (QALY).Result The risk-based strategy will prevent 352 cases of early-onset GBS for o5.0 million, indicating a costeffectiveness ratio of o7600 per QALY gained. The combined screening risk-based strategy has comparable results. The current Dutch guideline resulted in lower effects for higher costs. The screening-based strategy shows the highest reduction in cases of early-onset GBS, however, at a cost-effectiveness ratio of o59,300 per QALY gained. Introducing the polymerase chain reaction (PCR) test may lead to a more favourable cost-effectiveness ratio. Conclusion In the Dutch system, the combined screening/risk-based strategy and the risk-based strategy have reasonable cost-effectiveness ratios. If it becomes feasible to add the PCR test, the cost-effectiveness of the combined screening/risk-based strategy may even be more favourable.

Background and aims Studies have shown an association between Neonatal hearing loss (NHL) and preterm birth and low birth weight, but the prevalence of NHL more specific within these categories is not known. Aim of this study is to present the risk of NHL by week of gestation and categories of birth weight in an nationwide cohort of neonates born <32 weeks of gestation Methods Results of the two-stage Automated Auditory Brainstem Response (AABR) Universal Newborn Hearing Screening Program in Dutch neonatal intensive care units and diagnostic examination were centrally registered between October 1998 and December 2012 and included in this study. NHL was defined as impaired when the neonates’ conventional Auditory Brainstem Response (ABR) level exceeded 35 dB in one (unilateral) or two (bilateral) ears at diagnostic examination. Birth weight was stratified into <750 g, 750–999 g, 1000–1249 g, 1250–1499 g, and ≥1500 g. Results In total 18,564 neonates with a gestational age between 24.0 and 31.9 weeks were eligible for this study. Logistic regression analyses revealed significant associations between gestational age, birth weight and both unilateral and bilateral NHL (all p < 0.002). Gestational age (p < 0.001) and birth weight (p < 0.01) were both independent risk indicators of total NHL, and associated with NHL in a dose-response relationship. The prevalence of NHL consistently increased with decreasing week of gestation (1.2% to 7.5% from 31 to 24 weeks) and decreasing birth weight (1.4% to 4.8% from ≥1500 g to <750 g). Conclusions Gestational age and birth weight are independently associated with NHL in a dose-response relationship. This information can be used to gain insight into health and related costs associated with very preterm births. Abstract O-036 Figure 1

Background Among chickens, meat producing broiler strains are highly prone to develop severe pulmonary hypertension (PH) associated with endothelial dysfunction. However, pulmonary endothelial function appears to be unaffected during prenatal life.Objective To test the hypothesis that exposure to chronic prenatal hypoxia induces endothelial impairment and accelerates the development of PH in chickens prone to the disease.Methods Fertilized eggs from two genetic lines of broiler chickens differing in susceptibility to PH (high sensitivity: HS, low sensitivity: LS) were incubated under normoxic or hypoxic (15% O2) conditions from day 6 to day 19 of a 21-d incubation period. On day 19 isolated intrapulmonary artery segments were mounted in a myograph for isometric tension recording. The contractile responses induced by KCl as well as the relaxations induced by acethylcholine (ACh), the nitric oxide donor sodium nitroprusside (SNP), and the adenylate cyclase activator forskolin were tested.Results Hypoxia produced a reduction in the weight of the HS (31.1 Ϯ 0.6 g vs 27.3 Ϯ 0.6 g, PϽ0,001) and the LS (32.1Ϯ 0.6 vs 28.6 Ϯ 0.9 PϽ0,001) embryos. KCl-induced contraction was unaffected by hypoxia in both groups. Endothelium-dependent (induced by ACh) and -independent (induced by SNP and forskolin) relaxations were also unaffected by hypoxia in both groups. AChinduced relaxation was reduced by the NO synthase inhibitor L-NAME (10 mM) and abolished by the soluble guanylyl cyclase inhibitor ODQ (10 microM). L-NAME induced inhibition of ACh-induced relaxation was less marked in normoxic embryos of the HS group than in the other three groups.Conclusions Chronic hypoxia during incubation reduced embryonic growth but did not influence vascular reactivity in chicken embryos prone to postnatal pulmonary hypertension. INTESTINAL PERMEABILITY AND MECHANICAL VENTILATION IN PRE-TERM INFANTS CONCLUSIONS. IN CONTRAST TO OUR HYPOTHESIS, WE DID NOT FIND A HIGHER INTESTINAL PERMEABILITY IN MECHANICAL VENTILATED INFANTS COMPARED TO NON-VENTILATED INFANTS, MEASURED Ͻ48 H AFTER BIRTH. FURTHERMORE, WE DID NOT FIND A SMALLER DECREASE IN INTESTINAL PERMEABILITY IN THE FIRST WEEK OF LIFE IN VENTILATED INFANTS COMPARED TO NON-VENTILATED INFANTS. FURTHER STUDIES ARE NEEDED TO ELUCIDATE THE EFFECT OF MECHANICAL VENTILATION ON INTESTINAL PERMEABILITY IN PRETERM INFANTS. FOLLOW UP AFTER AABR NEONATAL HEARING SCREENING IN NICU GRADUATES.HLM VAN Goal To explore the severity and type of bilateral HL as wel as the prognostic value of the first diagnostic BERA.Methods NICU graduates with bilateral HL from one NICU (Zwolle) were included. Severity of HL was established as mild (20 -39dB), moderate (40 -59dB), severe (60 -90 dB) or profound (Ͼ90dB). Type of HL was conductive, perceptive, combined, or auditory neuropathy. Improvement of Ͼ 20 dB between the first BERA and observation audiometry at Ͼ 2 years at follow up was considered as clinically relevant.Results Severity of HL after first diagnostic BERA of 37 newborns with bilateral HL was 6 mild, 7 mo...