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CDC: Gaps persist in newborn screening for hearing loss, congenital heart disease
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Screening newborns for hearing loss and critical congenital heart disease can facilitate timely intervention, improving language outcomes in those with hearing loss and severe disability in those with heart disease, according to a recent Morbidity and Mortality Weekly Report.
“Newborn screening at birth is crucial to quickly identify infants at risk of hearing loss and congenital heart disease so they can receive early intervention and follow-up care,” Brenda Fitzgerald, MD, director of the CDC, said in a press release. “Finding these conditions early can give infants the best chance to properly develop and lead healthy lives.”
In the United States, critical congenital heart disease affects nearly two of every 1,000 births and includes 12 distinct structural heart disorders that limit the heart from transporting blood throughout the body, according to Scott D. Grosse, PhD, and colleagues. Screening for these conditions is limited to noninvasive pulse oximetry and diagnosis from a specialist. The researchers note that screening is particularly important because a normal appearance may warrant a discharge and later crises or death.
Although newer than early hearing detection and intervention (EHDI), only 48 states had laws or policies regarding screening for critical congenital heart disease as of 2016, and no federal funding exists to assist screening. Because of this, the CDC claims that 875 newborns with a critical congenital heart disease are not diagnosed before discharge annually. The organization notes that one in every 200 deaths resulting from congenital heart disease would be prevented if proper screening measures were implemented at birth.
Permanent hearing loss affects approximately the same number of infants, with nearly 1.6 of every 1,000 newborns having the condition in the U.S. Federally funded, state-based EHDI programs throughout the country have adopted the promotion of “1-3-6” plans, which include screening all infants at or before 1 month, performing diagnostic audiologic evaluation on those who failed screening at or before 3 months and implementing intervention for those diagnosed with hearing loss at or before 6 months.
Notably better language development has been observed in children with permanent hearing loss who were screened and received intervention between the ages of 3 to 6 months. These children also have fewer deficits in receptive and expressive language. Although screening is vital to the later outcomes of these children, the researchers note that those who are screened do not always receive timely evaluations or intervention.
“The collaboration between EHDI programs, health professionals and parents has led to great progress on hearing loss screening and follow-up,” Stuart K. Shapira, MD, PhD, chief medical officer and associate director for science at the CDC’s National Center on Birth Defects and Developmental Disabilities, said in the release. “We must apply the same effort and resources to critical congenital heart disease screening to help prevent infant deaths and offer children the greatest chance to thrive.” – by Katherine Bortz
Disclosure: Please see the study for a full list of relevant financial disclosures.
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