Eighteen year quality assurance of newborn hearing screening in Dutch neonatal intensive care units

K de Graaff-Korf1, Dr P Verkerk2, Dr P van Dommelen2, Dr Henrica (Irma) Van Straaten1

 1Isala Clinics, Zwolle, Netherlands,

2TNO Dept of Health, Leiden, The Netherlands


Objectives:To evaluate 18-year quality assurance of newborn hearing screening (NHS) in Dutch neonatal intensive care units (NICU).

Study design: Results of the two-stage automated auditory brainstem response (AABR) screening and diagnostic examination in NICU graduates were centrally registered between October 1998 and December 2016. This registration facilitates screening, tracking and follow-up after abnormal screening results. Outcome measures are referral rates, prevalence rate of hearing loss and (trends of) coverage rates and timeliness of follow-up.

Results: Sixty-three thousand one hundred and forty infants have been screened. Referral rates were 11.9% at the first and 23.1% at the second stage. Hearing loss was diagnosed in 1631 infants (2.5%). Of these infants, 1213 (1.9%) had a bilateral hearing loss and 418 infants (0.7%) an unilateral hearing loss. Coverage rates were 98.9% at the first, 94.9% at the second stage and 93.9% for the diagnostic examination. After correction for gestational age, 95.8% of the infants had their first AABR<1 month, 84.0% of the referred infants had their second AABR<6 weeks and 72.6% were diagnosed<3 months. The positive predictive value of hearing loss after AABR screening was 69%.Coverage rates increased over time (first stage >99% from year 2011 onwards, second stage >95% from year 2010 onwards).

Conclusions: The NHS in Dutch NICU’s is a high quality screening program . Coverage rates are improving over time.


Dr HLM (Irma) van Straaten  is neonatologist. She implemented and guided since1998 for 20 years a nationwide Dutch AABR NICU neonatal hearing screening program as medical coordinator as wel as research items in this field.


The Australasian Newborn Hearing Screening Committee aims to foster the establishment, maintenance and evaluation of high quality screening programs for the early detection of permanent childhood hearing impairment throughout Australia and New Zealand.

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