Investigation of losses in follow-up processes and associated factors in groups at risk after newborn hearing screening

This study aimed to determine the rate of loss to follow-up among infants who received a "pass" result in the initial newborn hearing screening but were identified as at-risk and scheduled for followup at six months. It also sought to evaluate parental awareness of late-onset hearing loss and their knowledge regarding associated risk factors. The study included 543 infants born at Hacettepe University between September 1, 2019, and June 15, 2024, who were classified as being in the at-risk group. The follow-up and non-follow-up infant groups were compared to identify potential differences; an evaluation was conducted with mothers who did not attend the hearing follow-up, using a questionnaire developed based on the reasons for non-attendance reported in the existing literature. Among the referred infants, 389 (72%) did not attend the 6-month follow-up. The most commonly stated reasons for non-attendance were forgetting (42%) and believing that follow-up was unnecessary (19%). In addition, 77% of parents stated that they had never heard of lateonset hearing loss, and 75% were unaware that their infants were considered at-risk in this context. According to the findings of the study, the likelihood of attending follow-up hearing screening was significantly lower for second (β = -1.117, p < 0.001) and third children (β = -0.807, p = 0.0225) compared to first-born children. The tendency to attend follow-up was found to be significantly higher among participants with risk factors such as prematurity, ventilatory support, ototoxic drug exposure, and a family history of hearing loss, compared to those without these risk factors (p < 0.001). Additionally, a moderate positive and statistically significant correlation was found between socioeconomic status and awareness of late-onset hearing loss (r = 0.42, p < 0.001). The findings indicate the necessity of utilizing health records in an integrated manner, informing parents through structured systems, and implementing awareness-raising strategies at the community level to ensure continuity in the follow-up of at-risk infants. Keywords: Newborn Hearing Screening, Risk Factors, Loss To Follow-Up, Late-Onset Hearing Loss