Newborn Hearing Screening Test: A Comparison between Infants in Neonatal Intensive Care Unit versus Nursery

Abstract

Objective: The purpose of this study is to compare the clinical characteristics of newborn hearing test results between infants in well-baby nursery (WBN) versus neonatal intensive care unit (NICU) and to determine the optimal strategies of hearing screening for each group. Methods: A total of 2,161 newborns admitted to WBN and NICU were enrolled in this retrospective cohort study. Automated audio brainstem response was used for hearing screening test. The screening rates, referral rates, prevalence rates, false positive rates and predictive positive value (PPV) were analyzed for infants in WBN and NICU. Results: The referral rates of the screening test were 2.2% and 5.0% in WBN and NICU groups (P<0.01); the prevalence rate of congenital hearing loss (HL) were 0.5% and 4.6% in the WBN and NICU groups (P<0.01). The false positive rates and PPV of screening test were 0.9% and 36.8% in WBN; 0.8% and 80% in NICU. Infants with bilateral refer results in both WBN and NICU were at the higher risk of congenital HL, compared with infants with unilateral refer results in WBN who were mostly confirmed to have false positive. Conclusion: The infants in WBN showed high unilateral referral rate with low prevalence rate of HL. However, the infants with bilateral refer results in WBN and uni- or bi-lateral refer results in NICU had higher prevalence rate of HL, compared with those with unilateral refer results in WBN. Different strategies for hearing screening might be considered in infants in WBN and NICU.