Establishment Of The Initial Network Of Newborn Hearing Screening In GanSu Province

Objective: To observe the prevalence of congenital hearing impairment among newborns and the relative influence factors of initial passing rate using transient evoked otoacoustic emission(TEOAE);To assess the feasibility of implementing a neonatal hearing screening at LanZhou city and set up the mode of NHS and a network of UNHS in Gansu province.Method: 1. using TEOAE to screen 488 newborns before discharge and observe that if there is a relation between initial passing rate and different days , gender , ways of delivery and side of ear . 2 . A two-stage hearing screening mode was adopted. Two types of equipment (OAE) were used to screen hearing of newborns from four hospitals of Lanzhou city before discharge and that failed in the initial screening 42 days later. Auditory brainstem response (ABR) was eventually used to confirm the diagnosis at the age of 3 months. 3 .All the mothers or fathers were well-informed about the screening procedures involved and the reasons for screening. 220 parents agreed randomly selected to fill in a questionnaire completed and returned a consent form prior to the testing.Result: 1. There were 488 newborns accepted hearing screening with TEOAE,there were 378 newborns passing the initial screening at two sides of ears and 46 newborns didn't pass at the same time at two ears,39 didn't pass only left ear and 25 didn't only right ear. The number of not passing is that: 85 ears are left,71 ears are right; 66 of 263 newborns after spontaneous delivery and 45 of 223 newborns after abdominal delivery didn't pass;67 of 276 mail newborns and 45 of 212 femail newborns didn't pass the first screening .The first not passing rate is different among diferrent days ages. 2. Two types of equipment (TEOAE) was used to screen hearing of newborns from four hospitals of LanZhou city before discharge and that failed in the initial screening 42 days later. Auditory brainstem response(ABR)was eventually used to confirm the diagnosis at the age of 3 months. From November 2005 to July 2006 , a total of 2015 newbowns were available but only 1271 newborns (63.0%) for initial screening before discharge from hospital. The rate of not passing initial screening using two types of OAE is 80 .9% and 89.2%,13.4%and 5.9%in rescreenig. Three cases were found to be hearing losing. 3 .The majority of parents (77.4%) conside it necessary to screen newborns heraring,but 13.7% parents consinde it not essential.Conclusion: 1.There is no relation between initial passing rate and ways of delivery , gender,and side of ear, but the not passing rate has a decreasing tendency with days increased. 3 days late would be the most appropriate time to perform the screening after birth. 2. OAE screening is an effective implement of hearing screening in early days. It is necessary and feasible to practice UNHS in Gansu province and Lanzhou city,but there are many problems needed to be solved. 3. Using OAE combines ABR(AABR) is an ideal mode for NHS,considing the condiction of the area, a two-stage hearing screening protocol would be protable mode. Considing the shortage of the two types of screening technology,it is essential to use behavioural audiometry and follow-up. 4. UNHS including screening,diagnosis, evaluation,followed-up and intervention. It is absolutely necessary and conditional to set up a network of UNHS in Gansu province.