Epidemiology of Early Hearing Loss Detection in Hawaii

Abstract

Objective. Universal Newborn Hearing Screening began in 2 Honolulu hospitals in 1992, and by 1999, all 14 civilian birthing facilities in Hawaii were providing screening. Examination of 1998 Hawaii data indicated that approximately 13% of infants who did not pass initial hearing screening in the hospital did not return for the indicated follow-up. The purpose of this study was to determine the epidemiologic profile of infants who were born in 1999 and did not return for follow-up. Methods. A population-based, cohort study of the hearing screening completion rates among the 13 civilian birthing facilities in Hawaii that provided data to the Department of Health was conducted. Analysis included a bivariate analysis of the demographic characteristics of infants who completed the screening/follow-up process compared with those who did not and logistic regression modeling to ascertain the demographic profile of infants at high risk for being lost to follow-up. Results. Of 12 456 infants, hearing screening data could be linked to the birth certificate file, and a final disposition regarding completion of the screening/follow-up process was determined for 10 328 (83%). Less than 2% (n = 176) of the linked infants failed to complete the screening/follow-up procedures. Low birth weight and white infants and infants born to women who had not completed high school were approximately twice as likely not to complete the screening as were their normal birth weight or nonwhite counterparts. Conclusions. Failure to complete the hearing screening follow-up may be related to cultural differences that have been previously reported in other maternal and child health studies of the diverse populations in Hawaii. The results of this study will allow the Hawaii Newborn Hearing Screening Program to target its efforts and limited resources toward infants who are at higher risk of not completing the screening and who may need special attention to encourage their mothers to complete the screening process, and to move quickly with rescreening infants whose initial tests are positive so that infants are not lost to follow-up.

Assessing Loss to Follow-up After Newborn Hearing Screening in the Neonatal Intensive Care Unit: Sociodemographic Factors That Affect Completion of Initial Audiological Evaluation

“…Younger maternal age was also associated with loss to follow-up in our study, consistent with the findings of Folsom et al (2000), where they found young maternal age as an independent predictor for loss to follow-up for study protocol after failed NHS among NICU and high-risk well-baby nursery patients. These findings contrast with prior studies that did not find maternal age to be a risk factor for completion of the NHS or loss to follow-up after failed NHS among non-NICU babies (Prince et al 2003; Liu et al 2008). Our findings support maternal age as a risk factor for loss to follow-up for the NHS unique to NICU babies.…”

Protocol and programme factors associated with referral and loss to follow-up from newborn hearing screening: a systematic review

“…When this factor was incorporated into the logistic regression model, the effect of other programme-level factors decreased. For instance, audiologist involvement reduced the impact of hospital size, which was otherwise shown to be an influential factor in other studies, with larger hospitals having lower LTFU rates compared to smaller hospitals [76,81,82]. Because of the multifaceted barriers that cause LTFU, an audiologist involved in the programme can monitor the performance outcomes of the screening and focus improvement plans within the local context.…”

“…Bigger hospitals with more annual births had lower LTFU rates, compared to smaller hospitals [76,81,82]. One study was the exception [68].…”

Sociodemographic Factors Affecting Loss to Follow‐Up After Newborn Hearing Screening: A Systematic Review and Meta‐analysis

“…Christensen et al 30 categorized maternal age as 13 to 24 years and ≥25 years, so in this case, 13 to 24 years were included as young maternal age, and ≥25 years were included as not young. Two studies initially divided maternal smoking status into 3 groups: current smokers, former smokers, and never smokers 21,31,32 . Of the remaining studies, only 2 differentiated smoking during pregnancy, 30,33 while 1 study simply differentiated lifetime smokers and nonsmokers 26 .…”

“…21,26 Racial and ethnic categories varied between studies, but most frequently were categorized as white, black, Hispanic, Asian, and other. Less frequently reported groups included American Indian/ Alaskan Native, 26,27,39,41 Native Hawaiian/Pacific Islander, 21,26,39,40 and Filipino. 21 These different classifications and the sometimes separation of race and ethnicity within studies made a comparison of individual racial categories difficult.…”