Preditores maternos e infantis associados a perda de seguimento do programa de triagem auditiva neonatal: estudo de coorte em maternidades do Nordeste do Brasil

Abstract

Introduction: It is estimated that the prevalence of congenital hearing loss is 1.7- 11/1000 live births, this occurrence can increase up to 10 times when we consider risk indicators for hearing loss. The early identification of hearing loss enables immediate and assertive intervention, offering conditions for the development of speech, language, social, psychological, and educational of these individuals, allowing a more favorable prognosis. The guidelines of newborn hearing screening programs in Brazil recommend diagnosis up to 6 months of age. Analyzing factors on the loss of follow-up for diagnosis or monitoring in these programs contributes information that can help in the effectiveness of family participation and in stronger collaboration between screening units and other health professionals who are in contact with the family, promoting thus, early diagnosis, the main objective of hearing screening. Objective: (1) To analyze maternal and child predictors associated with loss to follow-up in the newborn hearing screening program in maternity hospitals in northeastern Brazil. (2) Conduct a survival analysis on loss to follow-up in newborn hearing screening programs. Methodology: Dissertation structured in two articles (1) Retrospective cohort study, including secondary data from infants (n=604) who were referred for monitoring and/or diagnosis of the hearing screening program. Predictors evaluated included socioeconomic factors and maternal and child health factors. Statistical analysis was performed based on binary logistic regression models; method stepwise. (2) This is a secondary survival analysis study on the loss to follow-up of infants (n=604) referred for monitoring and/or diagnosis in neonatal hearing screening programs. The dependent variable was the time until the outcome occurred (loss to follow-up). Independent variables included socioeconomic factors and maternal and child health factors. For data analysis, the Kaplan-Meier method was used. Results: (1) The logistic regression model containing the number of prenatal care and the history of hearing loss in the family was significant [χ2(2) =34.271; p 5 prenatal cares and family history of hearing loss increases risks by 2.1 times compared to those who have no family history of hearing loss. It is important to provide subsidies for the implementation of improvements in public health that aim to advise, guide, and educate mothers, especially during prenatal care. (2) The prevalence of hearing loss is impacted by the rate of loss to follow-up within neonatal hearing screening programs. In this context, we believe that support and adaptation strategies of the programs can improve access and reduce the loss of follow-up in this process, as well as the importance of these services to reinforce the monitoring of those in an unfavorable social situation, with an organization centered on the Family.