伊朗西南部新生儿普遍听力筛查：大规模人群中的覆盖率、危险因素和结局
Universal newborn hearing screening in Southwest Iran: coverage, risk factors, and outcomes in a large-scale population.
文献信息
| PMID | 42827164 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Arash Bayat |
| 作者单位 | Department of Audiology, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. |
| 期刊 | European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery |
| SCI 分区 | Q1 |
| IF | 2.3 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
背景： 新生儿永久性听力损失可显著影响语言、认知和社会发展。新生儿普遍听力筛查（UNHS）有助于早期发现和干预，但覆盖率和随访仍不一致，尤其是在低收入和中等收入地区。伊朗西南部拥有庞大的出生队列和高近亲结婚率，为评估UNHS项目的表现及其相关新生儿危险因素提供了独特机会。
目的： 本研究的主要目的是评估伊朗胡齐斯坦省UNHS的总体覆盖率和失访率。次要目的是评估已确定的新生儿危险因素对听觉结局的影响。
方法： 这项前瞻性基于人群的队列研究纳入了2019年至2023年在胡齐斯坦省29个转诊中心接受筛查的所有新生儿。采用两阶段筛查方案，使用瞬态诱发耳声发射（TEOAE）和自动听性脑干反应（AABR），并对从筛查转诊的婴儿进行诊断性听力学检查。使用比值比（OR）及95%置信区间（CI）分析新生儿危险因素与听力损失之间的关联。
结果： 在450,542例活产中，403,833名新生儿（89.96%）接受了听力筛查。共有7,491名婴儿（1.85%）被转诊进行诊断评估，986例确诊为永久性听力损失，相当于每1,000例活产中2.44例的患病率。与普通婴儿室婴儿相比，入住NICU的婴儿患病率显著更高（每1,000例活产中11.6例 vs. 1.05例）。感音神经性听力损失占病例的78.49%，59.12%为双侧。总体而言，71.39%的受累婴儿至少有一个已确认的新生儿危险因素。在多变量分析中，早产（aOR=4.39；95% CI：1.38-11.81）、近亲结婚（aOR=4.14；95% CI：1.71-6.73）、新生儿高胆红素血症（aOR=3.14；95% CI：1.79-4.60）和听力损失家族史（aOR=3.29；95% CI：1.25-6.44）被确定为显著的独立预测因素。
结论： 伊朗西南部的UNHS实现了较高的覆盖率，并有效识别出永久性听力损失婴儿。针对高危人群的定向随访和早期干预对于优化听觉、言语和认知结局至关重要。
英文摘要
BACKGROUND: Permanent neonatal hearing loss can significantly impact language, cognitive, and social development. Universal newborn hearing screening (UNHS) facilitates early detection and intervention, yet coverage and follow-up remain inconsistent, especially in low- and middle-income regions. Southwestern Iran, with its large birth cohort and high prevalence of consanguinity, offers a unique opportunity to evaluate the performance of the UNHS program and its associated neonatal risk factors.
OBJECTIVE: The primary objective of this study was to assess the overall coverage and lost-to-follow-up rates of UNHS in Khuzestan Province, Iran. The secondary objective was to evaluate the impact of established neonatal risk factors on auditory outcomes.
METHODS: This prospective population-based cohort study included all newborns screened in 29 referral centers in Khuzestan Province from 2019 to 2023. A two-stage screening protocol using transient evoked otoacoustic emissions (TEOAEs) and automated auditory brainstem response (AABR) was applied, with diagnostic audiology for infants referred from screening. Associations between neonatal risk factors and hearing loss were analyzed using odds ratios (ORs) with 95% confidence intervals (CIs).
RESULTS: Out of 450,542 live births, 403,833 newborns (89.96%) underwent hearing screening. A total of 7,491 infants (1.85%) were referred for diagnostic assessment, and permanent hearing loss was confirmed in 986 cases, corresponding to a prevalence of 2.44 per 1,000 live births. The prevalence was markedly higher among NICU-admitted infants compared to well-baby nursery infants (11.6 vs. 1.05 per 1,000 live births). Sensorineural hearing loss accounted for 78.49% of cases, and 59.12% were bilateral. Overall, 71.39% of affected infants had at least one recognized neonatal risk factor. In multivariable analysis, prematurity (aOR = 4.39; 95% CI: 1.38-11.81), consanguinity (aOR = 4.14; 95% CI: 1.71-6.73), neonatal hyperbilirubinemia (aOR = 3.14; 95% CI: 1.79-4.60), and family history of hearing loss (aOR = 3.29; 95% CI: 1.25-6.44) were identified as significant independent predictors.
CONCLUSIONS: UNHS in southwestern Iran achieves substantial coverage and effectively identifies infants with permanent hearing loss. Targeted follow-up for high-risk populations and early intervention are critical to optimize auditory, speech, and cognitive outcomes.