Introducing universal newborn hearing screening in Denmark: Preliminary results from the city of Copenhagen

Abstract

In 2004 funding was made available by the government to introduce universal newborn hearing screening (UNHS) in Denmark. The funding was, however, limited to a two-year project with the results of the screening to be analysed at the end of the project period. This study presents the results from two Copenhagen hospitals after twelve months of screening the Hvidovre and Frederiksberg Hospitals. Before the UNHS started The Danish National Board of Health published guidelines for the screening. There were three main goals to be met:

• The detection of permanent hearing impairment in excess of 30dB in one or both ears.

• The screening process to be finished by the age of 30days (or within 30days after discharge from hospital for infants from the neonatal intensive care units).

• The coverage of the screening to be better than 80% of all newborns in the first year and 90% in the second year of the project period.

The UNHS started in February 2005 and the coverage during the first year was 98.5% of all children born at the Hvidovre and Frederiksberg Hospitals (n=6954). The great majority of the infants were screened when they were brought back to the hospitals at the age of four to 10days for metabolic screening tests. The referral rate was lower than expected at 1.4% after one or two screening attempts using transiently evoked otoacoustic emissions (TEOAE). During the first full 12months, 124 infants were referred for re-screening after the primary TEOAE and for further diagnosis. Of this group three infants (2.4%) did not show up and were lost to follow-up. The median age for the well babies when referred for re-screening was 10days and the re-screening was completed in another five days. For six of the 95 referred well babies the total screening period exceeded the recommended 30days. By spring 2006, 12 infants had been diagnosed with bilateral and four children with unilateral permanent hearing impairment (PHI). This indicates an incidence of moderate to profound bilateral PHI of 1.5/1000. Similarly, the incidence of unilateral PHI would be 0.5/1000 among the screened infants. These are, however, only preliminary figures, as 11% of the referred infants are still being investigated.

• universal newborn hearing screening
• transiently evoked otoacoustic emissions
• auditory brainstem response
• hearing impairment