Screening to detect permanent childhood hearing impairment in neonates transferred from the newborn nursery
Screening to detect permanent childhood hearing impairment in neonates transferred from the newborn nursery
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DOI：
10.1016/j.ijporl.2008.12.001
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发表时间：
2009-03-01
影响因子：
1.5
通讯作者：
Garabedian, Noel
中科院分区：
文献类型：
--
作者：
Dauman, Rene;Roussey, Michel;Garabedian, Noel
目的：本报告的重点是听力筛查的新生儿从常规托儿所转移到一个专门的领域。本研究的目的是：（1）确定在这一人群中是否实现了筛查覆盖率;（2）确定新生儿筛查和诊断随访之间的联系是否正确进行;（3）更好地确定这一高危人群中永久性儿童听力障碍（PCHI）的发生率。方法：每年平均有12 000名新生儿的六个人口中心（波尔多、里尔、巴黎、马赛、图卢兹和里昂）参加了该方案。自动听觉脑干反应（AABR）（Natus ALGO 3 i（R））筛查分两个阶段进行：即使用相同的技术对初始结果为“阳性”的婴儿进行第二次筛查。在研究期间出生的117，103名婴儿中，4972名新生儿被“转移”，构成了本报告的人群（占总出生人数的4.2%）。结果和讨论：将4972名“转移”新生儿的筛查结果与非转移新生儿的筛查结果进行比较（N = 112，131）。合格婴儿的筛查覆盖率在“转户”新生儿（筛查3 750名婴儿）中明显较低（75.4%），而非转户新生儿（筛查109 349名婴儿）的覆盖率为97.5%。第一阶段AABR后的阳性结果率在“转移”人群中（11.1%）高于非转移人群（6.5%）。在415名最初筛查呈阳性的“转移”新生儿中，91.3%按项目方案规定进行了复查。第二次放电前AABR确定，在一半的情况下，听觉功能已正常化的一天。在183名在新生儿筛查的两个阶段结束时结果仍然可疑的“转移”婴儿中（占受试人口的4.9%），只有70.5%返回听力中心进行诊断随访。双侧PCHI的发病率显着较高（4/1000）在“转移”的婴儿比在非转移population.Conclusions（1.08/1000）：在“转移”的婴儿获得普遍的筛查覆盖率的困难，不幸的是，在这个前瞻性的，多中心的研究验证。此外，我们的“转移”人口的多样性并不比仔细分析已发表的新生儿重症监护室（NICU）婴儿听力筛查研究所揭示的要大得多。风险因素及其或多或少复杂的组合的影响是显而易见的。(C)2008爱思唯尔爱尔兰有限公司保留所有权利。
Objectives: The focus of this report is hearing screening of newborns transferred from the regular nursery to a specialized area. The purpose of the study undertaken was: (1) to determine whether screening coverage in this population was achieved; (2) to establish whether the Linkage between neonatal screening and the diagnostic follow-up was carried out correctly; (3) to better determine the incidence of permanent childhood hearing impairment (PCHI) in this at-risk population.Methods: Six population centres averaging 12,000 births annually participated (Bordeaux, Lille, Paris, Marseille, Toulouse and Lyon). Automated auditory brainstem response (AABR) (Natus ALGO 3i(R)) screening was performed in two stages: i.e. infants with initial "positive" results were screened a second time using the same technique. Of the 117,103 babies born during the study period, 4972 neonates were "transferred" and comprised the population for this report (4.2% of the total births).Results and discussion: Screening results for 4972 "transferred" neonates were compared with those of non-transferred neonates (N = 112,131). Screening coverage of eligible infants was significantly tower (75.4%) in "transferred" neonates (3750 infants screened) compared to 97.5% coverage of non-transferred neonates (109,349 infants screened). The rate of positive results after the first stage AABR was higher in the "transferred" population (11.1%) than in the non-transferred population (6.5%). Of the 415 "transferred" newborns with initial positive screens, 91.3% were rechecked as stipulated in the project protocol. The second pre-discharge AABR ascertained that in half of the cases auditory function had normalized in the day. Of the 183 "transferred" infants whose result remained suspect at the conclusion of both stages of the neonatal screen (4.9% of the tested population), only 70.5% returned to the audiology centre for diagnostic follow-up. The incidence of bilateral PCHI was markedly higher (4/1000) in "transferred" infants than in the non-transferred population (1.08/1000).Conclusions: The difficulty of obtaining universal screening coverage in "transferred" infants was, unfortunately, verified in this prospective, multicentre study. Further, the diversity of our "transferred" population was not much greater than that revealed by careful analysis of published hearing screening studies in neonatal intensive care unit (NICU) infants. The influence of risk factors and their more or less complex combinations is apparent. (C) 2008 Elsevier Ireland Ltd. All rights reserved.