RESUMEN
OBJECTIVE: To understand the characteristics of postnatal hearing loss (PNHL) identified via different referral pathways, to inform childhood hearing screening and referral practices. DESIGN: Retrospective analysis of screening and audiology records. STUDY SAMPLE: A cohort of 385 children who passed newborn hearing screening in Queensland, Australia between September 2004 and December 2017 and were later diagnosed with permanent hearing loss. RESULTS: Neonatally identified risk factors facilitated detection for half the cohort, with PNHL detected earlier (average age of 31 months) and at a milder degree. PNHL was detected at an average age of 49 months via other pathways. Proportions of bilateral moderate or greater PNHL were greatest in children with significant medical circumstances (60.7%) and those with noted delays or concerns (39.2%), whereas childhood hearing screening programs detected greater proportions of unilateral moderate or greater PNHL (47.4%). CONCLUSIONS: Risk-factor-based surveillance detects PNHL early but does not detect all cases. Screening children with speech and language delays, parental or professional concern, or with relevant medical circumstances (eg meningitis or chemotherapy) is warranted based on the types of PNHL detected. Further evidence may be required to justify the rollout of postnatal population childhood screening programs.