Assessment of the national newborn screening programme for permanent hearing loss. Screening strategy and test performance

If not detected early, newborn hearing impairment can severely impact a child’s development. To address this issue, in 2014, France launched a nationwide newborn screening programme for permanent bilateral hearing loss (PBHL), targeting hearing loss ≥ 40 dB, in accordance with the 2007 HAS recommendations.

In 2022, the HAS was consulted by the French Ministry of Health to identify tools for improving the national newborn screening programme for PBHL and harmonising practices nationwide.

The assessment considered the data from the scientific literature, the opinion of a multidisciplinary working group that convened four times, and stakeholder consultation.

Following this work, the HAS recommends that national newborn screening be conducted:

• In both ears.
• At a threshold of 35 dB, incorporating two phases. The initial phase includes two tests (T1, T2) performed in the maternity or neonatal unit. The second phase (T3) is performed, if required, within the first month following birth.
• Before a corrected age of 1 month in preterm infants.
• With the consent of the parents or holders of parental authority, where applicable, obtained after they have been provided with complete and accessible information.

For infants who have not undergone hearing screening or who were born in an atypical context (e.g. early discharges, home births), the HAS recommends performing a catch-up phase.

The HAS has adapted its recommendations for newborns, both with and without risk factors (including cases without transfer to a neonatal unit), as well as for those transferred to a neonatal unit.

Furthermore, the HAS recommends implementing management and monitoring of the national newborn screening programme for permanent bilateral hearing loss, along the lines of the national programme for newborn blood spot screening. Additionally, it is advised to collect follow-up indicators validated by the programme’s governance to assess the programme's impact.