Abstract
Objective: To compare the hearing screening results of two-step transient evoked otoacoustic emissions (TEOAE) and one-step automatic auditory brainstem response (AABR) in non-risk newborns, and to explore a more suitable hearing screening protocol for infants discharged within 48 h after birth in remote areas of China.Methods: To analyze the age effect on pass rate for hearing screening, 2005 newborns were divided into three groups according to screening time after birth: <24, 24–48, and 48–72 h. All subjects received TEOAE + AABR test as first hearing screen, and those who failed in any test were rescreened with TEOAE + AABR at 6 weeks after birth. The first screening results of AABR and TEOAE were compared among the three groups. The results of two-step TEOAE screening and one-step AABR screening were compared for newborns who were discharged within 48 h. The time spent on screening was recorded for TEOAE and AABR.Results: The pass rate of TEOAE and AABR increased significantly with the increase of first screening time (P < 0.05), and the false positive rate decreased significantly with the increase of first screening time (P < 0.05). The failure rate of first screening of AABR within 48 h was 7.31%, which was significantly lower than that of TEOAE (9.93%) (P < 0.05). The average time spent on AABR was 12.51 ± 6.36 min, which was significantly higher than that of TEOAE (4.05 ± 1.56 min, P < 0.05). The failure rate of TEOAE two-step screening was 1.59%, which was significantly lower than one-step AABR.Conclusions: Compared with TEOAE, AABR screening within 48 h after birth can reduce the failure rate and false positive rate of first screening. However, compared with TEOAE two-step screening, one-step AABR screening has higher referral rate for audiological diagnosis. In remote areas of China, especially in hospitals with high delivery rate, one-step AABR screening is not feasible, and two-step TEOAE screening protocol is still applicable to UNHS screening as more and more infants discharged within 48 h after birth.
Highlights
Due to the high incidence of neonatal hearing loss, congenital hearing loss has become the focus of health management department of countries all over the world
One hundred eighty nine (9.4%) failed TEOAE or automatic auditory brainstem response (AABR) tests on one or both ears for the first screening among the 2005 newborns recruited for the study (Table 1)
This study mainly explored the effectiveness of TEOAE and AABR as first screening tool at different time after birth in non-risk newborns and compared the practicability of two-step TEOAE and onestep AABR screening methods for infants discharged with 48 h after birth
Summary
Due to the high incidence of neonatal hearing loss, congenital hearing loss has become the focus of health management department of countries all over the world. One ∼3 among 1,000 healthy newborns and 2∼4 among 100 high-risk neonates suffer from hearing loss as reported [1]. The purpose of neonatal hearing screening is to reduce the negative effects of hearing loss on child’s language, cognitive, social, emotional, and academic development through early detection [1]. The first neonatal hearing screening program was developed in the 1960s to screen newborns at high risk of hearing loss [3]. The importance of UNHS was recognized later as nearly half of newborns with congenital hearing loss are not from high-risk group [4]. Infants diagnosed with hearing loss should receive appropriate intervention from health care and education professionals before 6 months of age [5, 6]
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