Impact of COVID-19 on newborn hearing screening (NBHS) and early hearing detection and intervention (EHDI) services: A statewide analysis of differences and policy implications

Peter Kfoury; Jordan C Stout; Stephanie Browning McVicar; Max Sidesinger; Eun Kyung Jeon; Kathryn Tonkovich; Chelsea M Allen; Matthew A Firpo; Albert H Park

doi:10.1016/j.ijporl.2024.112187

Impact of COVID-19 on newborn hearing screening (NBHS) and early hearing detection and intervention (EHDI) services: A statewide analysis of differences and policy implications

Int J Pediatr Otorhinolaryngol. 2024 Dec 6:188:112187. doi: 10.1016/j.ijporl.2024.112187. Online ahead of print.

Authors

Peter Kfoury¹, Jordan C Stout², Stephanie Browning McVicar³, Max Sidesinger³, Eun Kyung Jeon⁴, Kathryn Tonkovich⁵, Chelsea M Allen⁶, Matthew A Firpo⁷, Albert H Park⁸

Affiliations

¹ Department of Otolaryngology - Head and Neck Surgery, University of Utah School of Medicine, Salt Lake City, UT, USA. Electronic address: peter.kfoury@hsc.utah.edu.
² Department of Otolaryngology - Head and Neck Surgery, University of Utah School of Medicine, Salt Lake City, UT, USA.
³ Utah Department of Health and Human Services, Salt Lake City, UT, USA.
⁴ Department of Communication Sciences and Disorders, University of Iowa, Iowa City, IA, USA.
⁵ Audiology, Primary Children's Hospital - Intermountain Health Care, Salt Lake City, UT, USA.
⁶ Department of Biostatistics, University of Utah, Salt Lake City, UT, USA.
⁷ Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT, USA.
⁸ Department of Otolaryngology - Head and Neck Surgery and Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, USA.

PMID: 39657360
DOI: 10.1016/j.ijporl.2024.112187

Abstract

Introduction: This study investigates the pandemic's impact on newborn hearing screening (NBHS) and access to hearing services for children in Utah. Specifically, it explores the differences in NBHS rates, diagnostic hearing testing, early intervention enrollment, and congenital cytomegalovirus (cCMV) screening before and during the pandemic.

Methods: Utilizing a comprehensive statewide Early Hearing Detection and Intervention (EHDI) database, we analyzed data from January 2017 to December 2021, excluding a 6-month period preceding March 16, 2020, to eliminate potential confounders related to pandemic onset. We assessed NBHS completion rates, time to diagnose hearing loss, early intervention referrals, and cCMV screening. Multivariable logistic regression analysis was employed to identify factors influencing timely completion of the EHDI milestones.

Results: Our study included 192,161 newborns in Utah. Although over 99 % of newborns underwent NBHS, differences were noted among those born in small towns, rural locations, home births, and self-pay situations. Births in metropolitan areas witnessed an increased proportion of NBHS and timely diagnostic ABR during the pandemic. While home births increased from 3 % of births in 2017 to 5 % in 2021, the proportion of home births who received NBHS also increased from 89.4 % pre-COVID to 96.2 % during the pandemic (p < 0.0001). The rate of timely ABR testing and EI services increased during the pandemic.

Conclusion: The COVID-19 pandemic did not considerably alter NBHS rates, and overall, the rates of timely ABR diagnosis and timely EI services in the state of Utah increased during the pandemic.

Keywords: COVID-19; Cytomegalovirus; Health services accessibility; Home childbirth; Neonatal screening; Newborn hearing screening; Pandemic preparedness.