Nearly one-third of children with early hearing loss pass newborn hearing screening

Universal newborn hearing screening (UNHS) as presently implemented misses almost one-third of newborns who have delayed onset of sensorineural hearing loss.

In a case review at 1 institution, newborns who passed UNHS were older at the time they were diagnosed and received cochlear implants later than their peers who failed UNHS, report researchers from Children’s Memorial Hospital in Chicago. Illinois mandated UNHS by law for use in all birthing hospitals in 2003.

Passing UNHS, especially in the absence of known risk factors, may falsely reassure parents and professionals, thus delaying diagnosis of hearing loss and cochlear implantation. To assess this possibility, the researchers examined data from 391 children who received cochlear implants at Children’s Memorial Hospital from 1991 through 2008.

Implant recipients were divided into those born before the mandated UNHS (264 children) and those born afterward (127 children).

Of the 127 children born after the mandate, 83 (65.4%) had a known cause of or at least 1 risk factor for sensorineural hearing loss, and 21 of those children (25.3%) passed hearing screenings.

Compared with children screened before the mandate, children screened afterward were significantly younger at diagnosis of hearing loss (21.4 vs 11.1 months, respectively), age at diagnosis of severe to profound hearing loss (34.8 vs 12.4 months), and age at implantation (5.1 vs 2.1 months).

In addition, children who failed screenings were diagnosed at a mean age of 5.9 months compared with the overall group’s mean average of 11.1 months. Those who failed screening also underwent implantation significantly earlier than those who passed or were not screened as newborns (average age, 1.7 vs 2.6 years).

Young NM, Reilly BK, Burke L. Limitations of universal newborn hearing screening in early identification of pediatric cochlear implant candidates. Arch Otolaryngol Head Neck Surg. 2011;137(3):230-234.