Missouri Newborn Hearing Missouri Newborn Hearing Screening Program: A Report Screening Program: A Report

on the First Two Yearson the First Two Years

Missouri Newborn Hearing Missouri Newborn Hearing Screening Program: A Report Screening Program: A Report

on the First Two Yearson the First Two Years

Missouri Department of Health and Missouri Department of Health and Senior ServicesSenior Services

Initial Hearing Initial Hearing Screenings Used in Screenings Used in Missouri HospitalsMissouri Hospitals

• Automated Auditory Brainstem Response(ABR)

• Otoacoustic Emissions (OAE)

OAE

A-ABR

Combination

19%

36% 45%

Statistics on Initial ScreeningStatistics on Initial ScreeningStatistics on Initial ScreeningStatistics on Initial Screening

Screening data for years 2002-2003150,476 newborns screened (97.6%

live births in state)5,613 referred to audiologists (3.7%)

Decline in ReferralsDecline in ReferralsDecline in ReferralsDecline in Referrals

0

1

2

3

4

5

2002 2003

PercentReferred

FromInitial

Screening

Re-ScreeningRe-ScreeningRe-ScreeningRe-Screening

• Summary level data is incomplete

• Difficulties getting hospitals/clinics to send re-screening information

•Technical issues with data entry on re-screening portion of hearing system

What happens to NewbornsWhat happens to NewbornsWho Fail their Initial Screen?Who Fail their Initial Screen?

20%

Seen byAudiologist

41%Pass subsequentScreening Test

39%

UnknownOutcome

Audiologist Exam ResultsAudiologist Exam ResultsNewborn Hearing Screening Program collected 1,213 audiologist reports from 2002 & 2003

67.8%Were seen by

AudiologistWithin

3 months of birth

32.2%Were not

seenwithin

3 months of birth

Audiologist Exam ResultsAudiologist Exam ResultsNewborn Hearing Screening Program collected 1,213 audiologist reports from 2002 & 2003

25%(299 Cases)

Diagnosis ofConfirmed Hearing

Loss 75%(914 Cases)

No Confirmed Hearing Loss

Confirmed Cases of Hearing LossConfirmed Cases of Hearing Loss

• 299 Confirmed Cases• Matched 287/299 records to Birth Certificate• 13 Cases infant passed initial screening but audiologist later confirmed hearing loss diagnosis• 43 Records removed—further testing revealed infants hearing were within normal ranges• Final data set contained 244 records

Confirmed Cases of Hearing LossConfirmed Cases of Hearing Lossby Date of Birthby Date of Birth

0

20

40

60

80

100

120

140

2002 2003

Number ofConfirmed

Cases

Hearing Loss byHearing Loss byGender and RaceGender and Race

0

0.5

1

1.5

2

2.5

3

Male

Female

White

Black

Other

HearingLossRatePer

1,000 Live

Births

Gender Race

Missouri State Average = 1.58

Hearing LossHearing Lossby Maternal Ageby Maternal Age

0

0.5

1

1.5

2

2.5

U18 18-19 20-24 25-29 30-34 35-39 40 &Over

Mother’s Age

Missouri State Average = 1.58

Hearing LossHearing Lossby Maternal Ageby Maternal Age

0

1

2

3

4

5

6

7

U20 20-24 25-29 30-34 35-39 40 &Over

HearingLossRatePer

1,000 Live

Births

Mother’s Age

Low Birth Weight All Births Regular Weight Only

Hearing Loss Hearing Loss by Birth Weightby Birth Weight

0123456789

10

VLB MLB > 2,500*1,500 –2,500*

< 1,500** grams

HearingLossRatePer

1,000 Live

Births

Hearing Loss byHearing Loss byAPGAR ScoreAPGAR Score

0

1

2

3

4

5

6

7

8

Normal < 5 < 7

After 1 Min. After 5 Min.

HearingLossRatePer

1,000 Live

Births

Hearing Loss &Hearing Loss &Cleft Lip/PalateCleft Lip/Palate

0

10

20

30

40

50

Non CL/P Cleft Lip/Palate

(7 Cases)

HearingLossRatePer

1,000 Live

Births

Hearing Loss by DegreeHearing Loss by Degree

MildModerateSevereProfound

Unknown

96

67

24

32

25

Hearing Loss by Type and DegreeHearing Loss by Type and Degree

SensorineuralConductiveMixedUnknown

120Cases

62

60

2

Type of Loss Degree of Hearing Loss forSensorineural Type Loss

MildModerateSevereProfound

Unknown

44

31

14

27

4

Severe and Profound Hearing LossSevere and Profound Hearing Loss

Type of Loss forSevere and Profound Hearing Loss

SensorineuralConductiveMixedUnknown

41Cases5

28

Unilateral/Bilateral Hearing LossUnilateral/Bilateral Hearing Loss

Unilateral/BilateralHearing Loss

BilateralUnilateralUnknown

124Cases

102

18

Unilateral/Bilateral for Severe or Profound Hearing Loss

BilateralUnilateralUnknown

3520

1

Days from Birth to DiagnosisDays from Birth to Diagnosis

0

20

40

60

80

100

120

140

Mild Moderate Severe Profound Unknown

Degree of Loss

Avg#Of

Days

3 Month Goal of NewbornHearing Program

=

Percent of Births MeetingPercent of Births MeetingThree Month GoalThree Month Goal

010

203040

50607080

90100

Mild Moderate Severe Profound Unknown

Degree of Loss

Overall 71.4% of Missouri newborns with hearing loss diagnosed by three month goal

SummarySummarySummarySummary

• Over 97% of newborns screened

• Missouri met ‘refer’ rate standards

• Elevated rates for select demographic characteristics

• Majority of newborns diagnosed by 3 month goal