Neonatal Hearing Screening in Intensive Care Units

Abstract

Background: Diagnosis of neonatal hearing impairment depends on universal hearing screening programs (otoacoustic emissions, OAEs, and/or auditory brainstem responses, ABRs). The aim of this study is to determine the prevalence of hearing impairment among high-risk newborns and identify the risk factors involved. Materials and methods:This is a prospective cohort study on 173 newborns hospitalized in a neonatal intensive care unit (NICU) with one or more risk factors for hearing impairment. Both TEOAEs and a-ABRs were performed a few days before discharge.Results: On examination with TEOAEs, 170 neonates eventually passed the test and 3 failed (1 bilaterally and 2 unilaterally). All neonates were also examined with a-ABR, and 10 failed the test, 7 of which passed TEOAE and were diagnosed as having possible auditory neuropathy spectrum disease (ANSD). The remaining 3 infants who failed both tests were diagnosed as having possible hearing loss (HL). From the risk factors, only TORCH infections were clearly related to the likelihood of hearing impairment, either ANSD or HL (p=0.004). The need for mechanical ventilation was also significantly higher in newborns with possible HL, compared to those with normal results (66.7% vs. 18.4%, p=0.03). Conclusions:Combined TEOAE/ABR is the gold standard examination for NICU infants due to the increased incidence of HL, especially ANSD, in this high-risk population.