title: Universal neonatal hearing screening in Flanders reveals socio-demographic risk factors for hearing impairment.
abstract: BACKGROUND
  Permanent congenital hearing impairment (CHI) occurs in approximately 1.4 per 1,000 newborns. Early treatment and rehabilitation is essential to prevent the delayed development of speech and language. This paper describes the special collaborative approach of the Flemish screening programme. It also discusses the results and the new insights into socio-demographic risk factors for CHI.
  
  
  METHODS
  In the period 1999-2008, the entire population of 628,337 newborns in Flanders was tested using an AABR hearing screener. Positive results were referred for confirmation of the CHI diagnosis to specialised referral centres. Socio-demographic factors were investigated to study any relationship with CHI.
  
  
  RESULTS
  The referral rate after two screenings was 2.7-7.2 per thousand of screened babies depending on the screener used. All children were referred to specialised centres and there was almost no loss to follow-up. The diagnosis of hearing loss was confirmed in 77-82% of the babies referred. The socio-demographic factors of gender, birth order and birth length, initial feeding type, level of education and origin of the mother were found to be independent predictors of CHI. Most of these risk factors can be linked to poverty. The observation that 50% of babies with CHI have no risk factors from the classic AAP list may be partly explained by the non-inclusion of socio-demographic risk factors.
  
  
  CONCLUSIONS
  This integrated programme opens up new perspectives for hearing-impaired babies. The social impact of the screening programme is considerable. A cluster of socio-demographic risk factors for CHI can be added to the classic AAP list.
authors.affiliation: Kind en Gezin (Child and Family), Brussels, Belgium. erwin.vankerschaver@scarlet.be
authors.forename: E
authors.initials: E
authors.lastname: Van Kerschaver
mesh_terms: D001530:Belgium / Q000453:epidemiology; D003710:Demography; D005260:Female; D034381:Hearing Loss / Q000151:congenital* / Q000175:diagnosis / Q000453:epidemiology*; D006320:Hearing Tests; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015997:Neonatal Screening / Q000458:organization & administration*; D012017:Referral and Consultation / Q000458:organization & administration; D012307:Risk Factors; D012959:Socioeconomic Factors