MULTIDIMENSIONAL ATTENTION TO NEONATAL HEARING HEALTH IN THE BRAZILIAN PUBLIC HEALTH SYSTEM (SUS): LONGITUDINAL EVIDENCE FROM SCREENING RETESTING BEFORE AND DURING THE COVID-19 PANDEMIC

Abstract

Introduction: Universal Neonatal Hearing Screening (UNHS) plays a fundamental role in the early identification of hearing loss in newborns. Risk factors for hearing impairment include a family history of hearing loss, prematurity, and exposure to ototoxic substances. In addition, COVID-19 may represent a relevant factor with the potential to affect the structures of the inner ear. Objective: To evaluate the hearing follow-up process related to UNHS retesting before and during the COVID-19 pandemic in neonates treated at an outpatient Hearing Health Care Service (HHS) in the state of Santa Catarina, with assistance from the SUS (Unified Health System). Methods: This is a retrospective longitudinal study that analyzed data from neonates treated at an SUS Hearing Health Care Service (HHS) from January 2018 to December 2022. Information related to UNHS and retest results was evaluated. Data analysis was performed using Microsoft Excel® and MedCalc® Statistical Software version 22.006, applying statistical measures and regression analyses to identify factors associated with failure in the Newborn Hearing Screening (NHS) and retesting. Results: A 2.6% absence rate in the retest was observed in the right ear and 2.2% in the left ear among the evaluated neonates. The average age of the mothers of newborns who failed the test was 33 years, while the overall average maternal age was 27 years. Failure in the retest and a longer interval between the initial NHS and the retest were associated with abandonment of the initial NHS retest (IRD). During the pandemic period, there was an increase in the rates of evasion for the NHS retest, as well as an increase in the time interval between the initial screening and the retest. Conclusion: Several factors, including the interval between examinations, maternal age, and clinical conditions, influenced the retest results. Furthermore, the pandemic contributed to a significant increase in dropout rates and to extending the time required for retesting.