一项区域性新生儿听力筛查项目的十一年基于人群的评估
Eleven-year population-based evaluation of a regional newborn hearing screening programme.
文献信息
| PMID | 42830358 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Andrea Lund |
| 作者单位 | Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Aarhus University Hospital, Aarhus N, Palle Juul-Jensens Boulevard 167, 8200, Aarhus, Denmark. andrealund@clin.au.dk. |
| 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： 普遍新生儿听力筛查（UNHS）已广泛实施，但对该项目表现的长期基于人群的评估仍然有限。本研究旨在评估一个区域性UNHS项目在11年期间的长期表现，重点关注不同筛查模式下的筛查覆盖率、转诊率和诊断结局。
方法： 这项回顾性基于人群的队列研究纳入了2015年至2025年丹麦中部地区所有活产婴儿。筛查路径分为三组：对无公认危险因素的婴儿仅进行自动听性脑干反应（AABR）筛查，对有公认危险因素的婴儿进行AABR与耳声发射（OAE）联合筛查，以及仅记录到OAE筛查的一组。项目结局包括筛查覆盖率、初次转诊率、最终转诊至诊断性听性脑干反应（D-ABR）率以及诊断阳性率。
结果： 在160,719名活产婴儿中，157,849名（98.2%）接受了筛查。总体而言，5,070名婴儿（3.2%）在初次筛查后被转诊。仅AABR筛查的初次转诊率为0.2%，而基于OAE的筛查路径约为15%（p < 0.001）。在转诊婴儿中，85.5%在听力学复筛时达到双耳通过，仅732名婴儿（占筛查婴儿的0.46%）进入D-ABR。其中，417名确诊听力损失（诊断阳性率57.1%）。
结论： 该项目的长期表现稳定，在结构化、风险适配的筛查模型中具有高筛查覆盖率和低最终转诊率。对无危险因素婴儿采用基于AABR的筛查与极低的初次转诊率相关，同时保持了诊断阳性率。这些发现支持在结构化UNHS项目中将AABR作为主要筛查模式。
英文摘要
BACKGROUND: Universal newborn hearing screening (UNHS) is widely implemented, but long-term population-based evaluations of programme performance remain limited. This study aimed to evaluate long-term performance of a regional UNHS programme over an 11-year period, focusing on screening coverage, referral rates, and diagnostic outcomes across screening modalities.
METHODS: This retrospective population-based cohort study included all live-born infants in the Central Denmark Region from 2015 to 2025. Screening pathways were categorised in three groups: automated auditory brainstem response (AABR)-only screening for infants without recognised risk factors, combined AABR and otoacoustic emissions (OAE) screening for infants with recognised risk factors, and a group in which only OAE screening was recorded. Programme outcomes included screening coverage, primary referral rate, final referral rate to diagnostic auditory brainstem response (D-ABR), and diagnostic yield.
RESULTS: Among 160,719 live-born infants, 157,849 (98.2%) underwent screening. Overall, 5,070 infants (3.2%) were referred after primary screening. Primary referral rates were 0.2% for AABR-only screening and approximately 15% for OAE-based screening pathways (p < 0.001). Of referred infants, 85.5% achieved bilateral pass at audiological rescreening, and only 732 infants (0.46% of screened infants) proceeded to D-ABR. Among these, 417 had confirmed hearing loss (diagnostic yield 57.1%).
CONCLUSION: The programme demonstrated stable long-term performance with high screening coverage and low final referral rates within a structured, risk-adapted screening model. AABR-based screening in non-risk infants was associated with a very low primary referral rate while maintaining diagnostic yield. These findings support the use of AABR as a primary screening modality within structured UNHS programmes.