Which Risk Factors Predict Postnatal Hearing Loss in Children?

Abstract

Targeted surveillance using a risk factor registry is the recommended method to detect hearing loss following the newborn screening period. However, currently, there is limited evidence linking some of the risk factors listed on the Joint Committee on Infant Hearing registry to postnatal hearing loss. The goal of this study was to investigate the risk factors that were most likely to predict the occurrence of postnatal hearing loss using formal analysis of a large cohort. A retrospective study of children referred to the targeted surveillance program in Queensland, Australia. This study involved children who were born in Queensland, Australia, between September 2004 and December 2009, had received a bilateral "pass" result during newborn hearing screening, had one or more risk factors identified during screening that triggered a referral to the targeted surveillance program, and had completed their follow-up audiology appointment series according to Queensland's diagnostic audiology protocols. Data for the cohort was extracted from the state-wide data management system Oz Systems eScreenerPlus (eSP). Data analysis included yield calculations for each risk factor, χ² analysis, and logistic regression analysis. During the study period, 2107 children met the inclusion criteria and were included in this study. Of these, 56 children (2.7%) were identified with a postnatal hearing loss. Statistical analysis revealed that two risk factors, family history (odds ratio [OR]: 1.92; 95% CI: 1.04-3.56), and craniofacial anomalies (OR: 2.61; 95% CI: 1.19-5.70) predicted the occurrence of postnatal hearing loss in children. In contrast, the risk factor of low birth weight (LBW) (OR: 0.14; 95% CI: 0.05-0.39) did not. This study suggests that children with the risk factors of family history and craniofacial anomalies should have their hearing monitored throughout early childhood, whereas children with the risk factor of LBW should not. Two additional risk factors, syndrome and prolonged ventilation, indicated favorable results for monitoring; however, a full analysis was unable to be completed due to statistical limitations. There was insufficient evidence within this study to support monitoring of children with the remaining risk factors of severe asphyxia, congenital infection, bacterial meningitis, professional concern, and hyperbilirubinemia. Further research with large cohorts of children with and without risk factors needs to be completed to further understand the relationship between risk factors and postnatal hearing loss.