Lorène Bouillot1, Maurice Vercherat2, Catherine Durand3. 1. Réseau Périnatal des 2 Savoie (RP2S), Centre Hospitalier Métropole Savoie, Chambéry, France. 2. Union Régionale pour la Prévention des Handicaps de l'enfant (URPHE), Lyon, France. 3. Réseau Périnatal des 2 Savoie (RP2S), Centre Hospitalier Métropole Savoie, Chambéry, France. Electronic address: catherine.durand@ch-metropole-savoie.fr.
Abstract
INTRODUCTION: Universal newborn hearing screening (UNHS) started as public health policy in 2015 in the French Rhône-Alpes region, aiming to screen for unilateral and bilateral hearing loss. After a first and second screening (retest) in the maternity hospital, the diagnostic process occurred at a limited number of specialist centers. A deferred preliminary screening (T3) was proposed before the age of 1 month. The aims of this study were to assess implementation of the program, impact of T3, and present the incidence of hearing loss in this population. MATERIALS AND METHODS: The retrospective observational study was based on data transmitted routinely by the 51 maternities to the regional organization responsible for newborn screening, in 2016 and first half of 2017. RESULTS: All the facilities implemented the UNHS protocol, with 47 out of 51 using the recommended techniques. 99.7% of the 115,435 newborns were screened (excluding 0.2% of parental refusals). A retest was required for 10.2% of the babies. Among babies who didn't pass retest, 7.7% were lost to follow-up. 2.2% of the newborns were referred to diagnostic centers. The rate of T3 was 31.3% of newborns who did not pass retest. 88.6% of the infants passed T3. In the perinatal network making extensive use of T3 (75.8% versus 14.9% elsewhere), 0.6% of the infants were referred to a diagnostic center, versus 2.9% in the rest of the region (2016, p < 0.001). For 2016, the outcomes at 6 months revealed an overall hearing loss rate of 1.7‰ (4.7‰ for neonatal care unit babies), and bilateral hearing loss in 1.2‰. CONCLUSION: In Rhône-Alpes, the national and regional objectives for UNHS were exceeded, although limiting the number of infants lost to follow-up remains essential. Repeating an automated test around 2-4 weeks after birth improves the program by decreasing the false positives of the screening. It considerably limits the number of infants referred to specialist centers, without increasing the number of patients lost to follow-up.
INTRODUCTION: Universal newborn hearing screening (UNHS) started as public health policy in 2015 in the French Rhône-Alpes region, aiming to screen for unilateral and bilateral hearing loss. After a first and second screening (retest) in the maternity hospital, the diagnostic process occurred at a limited number of specialist centers. A deferred preliminary screening (T3) was proposed before the age of 1 month. The aims of this study were to assess implementation of the program, impact of T3, and present the incidence of hearing loss in this population. MATERIALS AND METHODS: The retrospective observational study was based on data transmitted routinely by the 51 maternities to the regional organization responsible for newborn screening, in 2016 and first half of 2017. RESULTS: All the facilities implemented the UNHS protocol, with 47 out of 51 using the recommended techniques. 99.7% of the 115,435 newborns were screened (excluding 0.2% of parental refusals). A retest was required for 10.2% of the babies. Among babies who didn't pass retest, 7.7% were lost to follow-up. 2.2% of the newborns were referred to diagnostic centers. The rate of T3 was 31.3% of newborns who did not pass retest. 88.6% of the infants passed T3. In the perinatal network making extensive use of T3 (75.8% versus 14.9% elsewhere), 0.6% of the infants were referred to a diagnostic center, versus 2.9% in the rest of the region (2016, p < 0.001). For 2016, the outcomes at 6 months revealed an overall hearing loss rate of 1.7‰ (4.7‰ for neonatal care unit babies), and bilateral hearing loss in 1.2‰. CONCLUSION: In Rhône-Alpes, the national and regional objectives for UNHS were exceeded, although limiting the number of infants lost to follow-up remains essential. Repeating an automated test around 2-4 weeks after birth improves the program by decreasing the false positives of the screening. It considerably limits the number of infants referred to specialist centers, without increasing the number of patients lost to follow-up.