Evaluating the reach of universal newborn hearing screening in Colorado.
BACKGROUND
Children's language and developmental delays can result from a late diagnosis of hearing loss. To improve population-based prevention efforts to reduce such delays, Colorado's early hearing detection and intervention program examined the determinants of receiving timely newborn hearing screening to better support early identification and treatment of hearing loss.


METHODS
In 2006-2007, data were examined from the state's electronic birth certificate regarding hospital, infant, and maternal characteristics. From January 2002 through December 2004, there were 204,694 hospital births; 98% of newborns were screened for hearing loss. Of those receiving a positive (failed) result, 82% then received outpatient follow-up screening.


RESULTS
Newborns with normal Apgar scores were ten times more likely than infants with low Apgar scores to receive initial hearing screening; newborns with normal birth weights were four times more likely than newborns with low birth weights to receive initial hearing screening. Outpatient follow-up screening was associated with hospitals' screening performance and mothers' education. One urban safety-net hospital substantially reduced the state's follow-up screening disparities.


CONCLUSIONS
While newborns with low Apgar scores and birth weights are more likely to have a higher risk of hearing loss than infants with normal Apgar scores and birth weights, they are substantially less likely to receive screening to identify it.
Christensen
Mathew
M
Colorado Department of Public Health and Environment, Denver, Colorado 80246, USA. mathew.christensen@state.co.us
Thomson
Vickie
V
Letson
G William
GW
D001034:Apgar Score; D001724:Birth Weight; D003120:Colorado / Q000453:epidemiology; D034381:Hearing Loss / Q000175:diagnosis / Q000453:epidemiology*; D006320:Hearing Tests / Q000379:methods / Q000706:statistics & numerical data*; D006761:Hospitals; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D015997:Neonatal Screening / Q000706:statistics & numerical data*; D012306:Risk; D012959:Socioeconomic Factors; D013997:Time Factors