Hearing Impairment In Newborns Research Articles

Newborn concurrent hearing and genetic screening for hearing impairment: A systematic review and meta‑analysis.

Hearing loss is the most prevalent neurosensory disorder in humans, with significant implications for language, social and cognitive development if not diagnosed and treated early. The present systematic review and meta-analysis aimed to determine the rate of hearing screening pass and genetic screening failure [universal newborn hearing screening (UNHS) pass/genetic failure] and to investigate the advantages of combining newborn hearing and genetic screening for newborn hearing impairment. The PubMed, Embase and Cochrane databases were searched from inception to September 2023 to identify studies reporting the combination of neonatal hearing screening with genetic screening. Duplicate literature, unpublished literature, studies with incomplete data, animal experiments, literature reviews and systematic studies were excluded. All the data were processed by STATA15.1 statistical software. A total of nine cross-sectional studies were included in this meta-analysis. The sample sizes ranged from 1,716 to 180,469, and there were a total of 377,688 participants. The pooled results revealed that the prevalence of passing the UNHS while failing genetic screening was 0.31% (95% CI, 0.22-0.41%). The prevalence of UNHS pass and gap junction protein beta 2 and solute carrier family 26 member 4 variant screen failure was 0.01% (95% CI, 0.00-0.02%) and 0.00% (95% CI, 0.00%), respectively, while the prevalence of mitochondrially encoded 12S RRNA variant screening failure and UNHS pass was 0.21% (95% CI, 0.18-0.26%). Combined screening has a significant advantage over pure hearing screening, especially in terms of identifying newborns with mitochondrial gene mutations that render them sensitive to certain medications. In clinical practice, decision-makers can consider practical circumstances and leverage the benefits of combined newborn hearing and genetic screening for early diagnosis, early counseling, and early intervention in patients with hearing loss.

Prevalence and risk factors of hearing loss in high-risk neonates at a tertiary care hospital in Mumbai

Background: The present study was conducted to assess the prevalence of hearing loss using measurements of otoacoustic emission (OAE) in newborns admitted to NICU and to determine the risk factors predictive of hearing impairment in these newborns. Methods: This was a Prospective observational study conducted among 220 newborns admitted to the NICU over 18 months. Ethical clearance was obtained from the IEC. The sample size was obtained by the universal sampling technique. All candidates underwent hearing assessment in a sound-treated room in the department using a distortion product OAEs (DPOAE) test at the time of discharge. Babies who did not pass the initial screening underwent another OAE test within one month after being discharged. If they failed the test again, they were referred to an otologist for BERA. Results: Of the 226 neonates included in the study, 40 cases (17.7%) failed the initial screening. 29 cases (12.8%) failed the second OAE screening and were subjected to BERA. Risk factors included asphyxia (p≤0.001), mechanical ventilation (p<0.0004), history of ototoxic medication (p=0.004), neonates with hyperbilirubinemia requiring exchange transfusion (p=0.005), low Apgar scores (p≤0.001). Conclusions: A two-stage OAE hearing screening can be a suitable method for early detection of hearing impairment in newborns. This method has shown high prevalence of hearing loss among high-risk neonates but needs to be confirmed with diagnostic BERA. It is crucial to have universal hearing screening to detect the large number of hearing-impaired neonates in the newborn population of our country, including those who are not considered at risk.

Cochlear implantation compliance among minorities at high risk for hearing impairment following universal newborn hearing screening.

The universal newborn hearing screening (UNHS) allows for early detection of hearing impairment (HI). The goal of this current study was to evaluate the impact of cultural background involving consanguineous marriage on newborn HI diagnosed using UNHS, and compliance with hearing rehabilitation. This is a retrospective cohort study that included all children born at a single tertiary medical center between 2011 and 2017 who did not pass the UNHS (oto-acoustic emission and auditory brainstem response), and were diagnosed with HI. The study group included children from consanguineous marriage cultural background which were compared to a control group-all other children. Data were retrieved from the computerized medical charts and included epidemiological, audiological, and pregnancy/delivery-related data, and known risk factors for congenital HI. A total of 238 (196 study and 42 control) neonates were diagnosed with HI. Family history of HI was significantly more prevalent in the study group in mild-severe and profound HI subgroups (p = 0.03 and 0.01, respectively). Study group demonstrated lower rates of cochlear implantation (CI) compliance (p = 0.079), performed at a significantly older age (23 months (IQR 17-36.5) vs. 16 (IQR 12-26) months, p = 0.021). When recommended, bilateral CI compliance was significantly lower in the study group (94.1 vs.48.9%, p < 0.001). UNHS allows for early HI detection among minority populations at higher risk for CI, yet compliance rates remain lower compared with control. Familiarity of families with the importance of early detection and HI risk may result in higher compliance rates for cochlear implantation. Health providers should aim to improve education and communication with this unique group of patients and consider health promotion programs.

The prevalence of risk for hearing impairment in newborns with congenital syphilis in a newborn hearing screening program (NHS).

To study the prevalence of risk for hearing impairment in neonates with congenital syphilis in a newborn hearing screening program. The study design is retrospective, documentary, and is cross-sectional. The sample consisted of newborns who were born between January 2019 and December 2021 and who underwent neonatal hearing screening in a public maternity hospital. Demographic data and the presence and specification of risk indicators for hearing impairment (RIHL) were collected. In retest cases, the results and the final score were also collected. For data analysis, the Kruskal-Wallis and Conover-Iman post-hoc tests were used, comparing the groups that passed and failed the hearing screening that had RIHL, using a significance level of p of <0.5. Among the RIHL observed in the sample, prematurity was more frequent in newborns who passed the screening (55.26%) than in those who failed the test (45.67%). Congenital syphilis was the ninth most frequent RIHL (8.04%) among the newborns who passed the test and the 15th factor (3.03%), with the highest occurrence in those who failed the hearing screening. When comparing the two groups (pass and fail), we found significant differences (p < 0.05) between them. Congenital syphilis was the ninth risk indicator for the most common hearing impairment and, in isolation, did not present a risk for failure in neonatal hearing screening. Notably, congenital syphilis can cause late hearing loss during child development. Thus, there is an indication of audiological monitoring of these neonates.

Evaluation of the Brain Stem Auditory Evoked Potential Response among New Borns Post-Recovery after Hyper-Bilirubinemia: An Original Research.

Neurological harm from neonatal hyperbilirubinemia includes loss of hearing and encephalopathy. The current research used the "Brainstem Evoked Response Audiometry (BERA)" test to screen for as well as assess hearing loss in newborns who had recovered from hyperbilirubinemia. A cross-sectional comparative investigation was conducted at a tertiary care center. Fifty neonates were included out of which 25 were healthy and 25 received treatment for the increased bilirubin. Prior to BERA testing, the subjects' ears were examined for any obstruction. Following a conventional lab procedure described, the BERA recordings were carried out after the neonate fell asleep on its own. The data collected were compared for the significance using the ANOVA, keeping P < 0.05 as significant. In comparison to the controls, a large proportion of neonates in cases had BERA wave latencies that were delayed (I-R = 80, L = 84; III- R = 76, L = 84; V- R = 84, L = 88 percentages latencies). The percentage of subjects in whom the latencies was noted for the healthy neonates was lesser than the case group (I-R = 8, L = 24; III- R = 8, L = 8; V- R = 4, L = 12 percentages latencies). Comparable numbers of infants in each group had inter-peak latencies that were lengthy. Subjects in the case group showed that the threshold hearing as per the WHO grade was mild (R = 32, L = 36) and moderate (R = 32, L = 28). Elevated serum bilirubin may cause damage to hearing capability. After hyperbilirubinemia has been completely treated, BERA can detect even the slightest degree of hearing damage. BERA is therefore a useful technique for the quick recognition of hearing impairment in newborns. Early treatment helps in the prognosis so that the neurosensory systems can fully mature, and the patient can lead a quality life.

СТАНОВЛЕНИЕ, РАЗВИТИЕ И СОВЕРШЕНСТВОВАНИЕ СИСТЕМЫ АУДИОЛОГИЧЕСКОГО СКРИНИНГА НОВОРОЖДЕННЫХ И ДЕТЕЙ ПЕРВОГО ГОДА ЖИЗНИ В РОССИИ

Early detection of hearing impairment in newborns and children of the first year of life is relevant due to its high prevalence and negative impact on the development of the child. The etiology and epidemiology of this pathology are studied well; there are modern effective methods for diagnosing the auditory system as well as for correcting the lost auditory function. Therefore, the congenital hearing loss complies with all principles of disease screening. Specialists from the National Research Centre for Audiology and Hearing Rehabilitation (NRCAHR, located in Moscow, Russia) together with perinatologists have been systematically implementing a unified system for the early detection of hearing impairment for many years, which is being implemented starting the neonatal period of life. The Program of universal audiological screening of newborns and children of the first year of life was implemented in all Russia regions in 2008 - 2010 based on the NRCAHR methodological developments, and 95% coverage of all newborns was achieved in a few years. This review presents the current state of the abovementioned Program, its legal framework, and the results of the 2020 audiological screening. The issues of further improvement of the system dedicated to enhancing of the efficiency of early detection and rehabilitation of children with congenital and pre-speech hearing loss are considered as well.

Risk Factors Associated with Newborn Hearing Impairment in the Neonatal ICU of a Tertiary Hospital

Introduction: Hearing impairment has a devastating, detrimental, and adverse impact on the development of the newborn. Unfortunately, this hidden disability remains undetected for many newborns until it is too late to prevent undesirable and often irreversible damage. It has long been recognized that undiagnosed hearing loss, even a mild loss at birth, can negatively affect speech and language development, Resulting in poor academic achievement and social-emotional development. According to WHO 2009, newborns in the NICU are 10-20 times at higher risk of developing hearing loss. The risk factors associated with newborn hearing impairment vary from country to country and even within countries. There has been a paucity of studies on this topic from Bangladesh. This study was done to identify the risk factors associated with newborn hearing impairment in the study place. The objective of the study: To identify risk factors associated with newborn hearing impairment in the study group.&#x0D; Methodology: A prospective observational study was conducted in the department of neonatology, BSMMU. After taking consent from the parents/guardians, a thorough history of these newborns, including particulars of the neonates, family history of hearing loss, treatment history, antenatal, natal, and postnatal history, was recorded in a data collection form. Newborn admitted to the NICU during the study period was the study population. The newborn who meet the inclusion criteria was screened with Transient Evoked Otoacoustic Emissions (TEOAE) close to discharge from the NICU or before one month of age. A second screen was done with TEOAE again after one month of 1st screen but prior to 3 months of postnatal age if referred in 1st screen. Diagnostic Auditory Brain stem Response (ABR) was made to confirm the hearing impairment, and it was done prior to 3 months of postnatal age if referred in both the 1st and 2nd screens. Data were analyzed by statistical package for social sciences (SPSS) version 20.&#x0D; Results: 426 valid recordings from 493 newborns admitted in the NICU enrolled consecutively constitute the basis of this study. 14 newborns were found to have hearing impairment among 426 newborns. APGAR ≤ 6 at 5 minutes (odds ratio 20.34, p-value 0.01), TORCH infection (odds ratio 0.64, p-value 0.01), IUGR odds ratio 8.92, p-value 0.02) were independent significant risk factors for hearing impairment.&#x0D; Conclusion: APGAR ≤ 6 at 5 minutes, TORCH infection, and IUGR are independent significant risk factors for newborn hearing impairment. Newborns in NICU with these risk factors should have mandatory audiological evaluation.&#x0D; TAJ 2022; 35: No-2: 59-65

Comparison of hearing screening outcomes in newborns of gestational diabetic and non-diabetic mothers: a prospective, controlled study

Objectives To investigate whether Gestational diabetes mellitus (GDM) is related to presumptive hearing impairment in newborns. Study design The newborns were divided into two groups. The first group included the children of gestational diabetic pregnancies (DPs), and the second group, the children of non-gestational diabetic pregnancies (NDPs). Transient evoked otoacoustic emissions (TEOAE) and automated Auditory Brainstem Response (aABR) tests were applied as hearing screening tests. Results Twenty (40.8%) newborns in the DPs group and 5 (7.7%) newborns in the NDPs group failed the first hearing screening test (p = .001). The number of newborns with bilateral failed hearing screening tests was higher in the DPs group at the first screening (75% vs. 20%, p = .04). Fifteen (75.0%) of 20 newborns in the DPs group and 1 (20.0%) of 5 newborns in the NDPs group failed the second TEOAE hearing screening test (p = .04). Conclusion The possibility of presumptive hearing impairment is higher in the newborns of mothers with gestational diabetes compared to the newborns of non-diabetic mothers.

Hearing Screening to Evaluate the Status of Newborn Hearing Impairment in the NICU of a Tertiary Hospital

Introduction: One to three per 1,000 live births suffers from significant hearing impairment. However, 2 to 4 per 100 infants who survived neonatal intensive care have some degree of sensorineural hearing loss. If hearing impairment in newborns is detected earlier, early management can prevent undesirable and often irreversible damage due to late detection. Early detection and the treatment of hearing impairment in children are essential for the development of communication skills, social skills, emotional well-being, and positive self-esteem. Unfortunately, this disability remains undetected for many newborns until it is too late to prevent undesirable and often irreversible damage. Unfortunately, not many studies were done on this topic in Bangladesh. The magnitude of the burden of hearing impairment in the study place might be identified by this study. The objective of the study: Hearing screening was done to see the status of hearing impairment in newborns admitted to NICU.&#x0D; Methodology: A prospective observational study was conducted in the department of neonatology, BSMMU. Newborn admitted to the NICU during the study period was the study population. The newborn who met the inclusion criteria was screened with TEOAE close to discharge from the NICU or before one month of age. A second screen was done with TEOAE again after one month of 1st screen but prior to 3 months of postnatal age if referred in 1st screen. Diagnostic ABR was done prior to 3 months of the postnatal age if referred in both the 1st and 2nd screen.&#x0D; Results: 426 valid recordings from 493 newborns admitted to the NICU enrolled consecutively constitute the basis of this study. Fourteen newborns were found to have hearing impairment among 426 newborns (3.3%). 2 newborns had unilateral hearing loss, and their hearing losses were moderate in nature. The other 12 newborns in their 24 ears had different grades of hearing loss. It was mild hearing loss in 3 ears, moderate in 9 ears, severe in 8 ears, and profound in 4 ears.&#x0D; Conclusion: Hearing screening showed that 3.3% of newborns in the NICU have a hearing impairment. It is still an underestimation considering the number of newborns who were lost to follow-up.&#x0D; TAJ 2022; 35: No-1: 77-82

Otoacoustic emission (OAE) features in newborns at Dr. Kariadi Central Genetal Hospital, Semarang, Indonesia

The joint committee on infant hearing (JCIH) recommends the detection and intervention of hearing impairment in newborns. Dr Kariadi Central General Hospital, Semarang, Indonesia is a referral hospital in Central Java province that has implemented an early detection program for hearing lossin newborns. Screening or early detection using otoacoustic emissions (OAE). This study aimed to find out the description of OAE in newborns at Dr. Kariadi Central General Hospital, Semarang. This research was a descriptive analytic using secondary data the OAE results on newborns with or without risk factors (FR) who are treated at Dr. Kariadi Central General Hospital, Semarang in 2020. The result of OAE pass meant that the outer hair cell (OHC) was functioning properly in both ears while refer was if the OHC in one ear or both was not functioning properly. Total 1338 newborns with and without FR whose OAE pass resulted as much as 1297 (97%) and refer 41 (3%). Most risk factors were low birth weight 331 (42%) with the results of OAE pass 312 (94.3%), and refer 19 (5.7%). In conclusion, this study shows that OAE passed in 97% of newborns.

Assessment of hearing in newborns with hyperbilirubinemia using otoacoustic emmisions and brainstem evoked response audiometry

The early linguistic age when language and speech skills develop is between 3-5 years. Speech is essential for communication and hence an important part of a normal life. Permanent hearing loss in children remains a public health problem and hence its prevention is an utmost important public health programme -The National Programme for Prevention and Control of Deafness. Neonatal hyperbilirubinemia is seen in about 2.3% of newborns. It is a common adverse effect that puts neonates at a high risk for hearing impairment. Bilirubin encephalopathy is due to raised unconjugated (indirect) bilirubin. Unconjugated bilirubin crosses the blood-brain barrier and, because it is lipid soluble, it penetrates neuronal and glial membranes too. Most of the tests used for assessing the hearing status in an individual require the cooperation of the subjects which is obviously not found in infants. Therefore, objective tests not requiring the infant’s cooperation can be used effectively. This study uses oto acoustic emissions (OAE) test as a screening test, and brain stem evoked response audiometry test (BERA) as a definite test for assessment of hearing in newborns with hyperbilirubinemia. To assess hearing impairment in newborns with hyperbilirubinemia.

Knowledge and Attitude of Nurses Regarding Newborn Hearing Impairment and Screening at Health Centers and clinics in Assiut City

Knowledge and Attitude of Nurses Regarding Newborn Hearing Impairment and Screening at Health Centers and clinics in Assiut City

ОСОБЕННОСТИ РЕГИСТРАЦИИ ОТОАКУСТИЧЕСКОЙ ЭМИССИИ У ДЕТЕЙ ПЕРВЫХ 3-Х МЕСЯЦЕВ ЖИЗНИ ПОСЛЕ ПЕРЕНЕСЕННОГО ОСТРОГО СРЕДНЕГО ОТИТА

Data on the frequency and nature of hearing impairment in newborns and children during the first months of life after acute otitis media are contradictory. Otoacoustic emission is one of the methods for assessing the hearing function in infants. The main advantages of this method are objectivity, non-invasiveness, speed and accuracy. Objectives. To evaluate the features of otoacoustic emission registration at the frequency of the product distortion in children of the first 3 months of life after an acute inflammation of the middle ear. Material and methods. Distortion-product otoacoustic emission was performed in 36 children after complete recovery from acute otitis media (main group) and in 32 children without otitis media (comparison group). The estimation of the amplitude and spectrum of the response received was performed. The analysis of the otoacoustic response at frequencies of 1 kHz, 1.5 kHz, 2 kHz, 3 kHz, 4 kHz, 5 kHz, 6 kHz, 8 kHz was carried out. Results. Otoacoustic emission was registered in 74.2% of investigations in the comparison group, in 56.0% of observations in otoscopically healthy ears in case of unilateral inflammation, in 35.1% of cases after a non-suppurative form of the disease, and only in 15.4% of cases after a purulent form of acute otitis media. Statistically significant differences were revealed in the frequency of registration of otoacoustic emission in children of the examined groups. The greatest amplitude of the signal/noise relationship was recorded at frequencies of 5 and 6 kHz, and the smallest one at the frequency of 1 kHz in all studied groups. Conclusions. A decrease in auditory function is observed in children of the first 3 months of life after past acute otitis media. This is confirmed by significantly higher rate of absence of otoacoustic emission in this group of patients. Distortion-product otoacoustic emission in children of the first 3 months of life is recommended to be carried out at frequencies of 1.5 kHz and higher.

Etiology of newborn hearing impairment in Guangdong province: 10-year experience with screening, diagnosis, and follow-up.

Hearing impairment is one of the most common birth defects in children. Universal newborn hearing screenings have been performed for 19years in Guangdong province, China. Ascreening/diagnosis/intervention system has gradually been put in place. Over the past 10years, a relatively complete data management system had been established. In the present study, an etiological analysis of newborn cases that failed the initial and follow-up screenings was performed. The nature and degree of hearing impairment in newborns were confirmed by a set of procedures performed at the time ofinitial hearing screening, rescreening and final hearing diagnosis. Then, multiple examinations were performed to explore the associated etiology. Over a period of 10years, 720 children were diagnosed with newborn hearing loss. Among these children, 445 (61.81%) children had a clearly identified cause, which included genetic factor(s) (30.56%), secretory otitis media (13.30%), maternal rubella virus infection during pregnancy (5.83%), inner ear malformations (4.86%), maternal human cytomegalovirus infection during pregnancy (2.92%), malformation of the middle ear ossicular chain (2.50%) and auditory neuropathy (1.81%). In addition, 275 cases of sensorineural hearing loss of unknown etiology accounted for 38.19% of the children surveyed. Long-term follow-up is needed to detect delayed hearing impairment and auditory development in children. The need for long-term follow-up should be taken into account when designing an intervention strategy. Furthermore, the use of the deafness gene chip should further elucidate the etiology of neonatal hearing impairment.

A study on prevalence of hearing impairment in newborns with birth asphyxia admitted to neonatal intensive care unit

Background:Hearing is a vital part of a newborn’s contact with his environment. Consequences of perinatal asphyxia range from death to various degrees of neuro-developmental sensory or motor deficits. One of its well-known sequelae is sensorineural hearing impairment. Hence this study was undertaken to find the prevalence of hearing impairment in inborn neonates with birth asphyxia. Methods: Prospective Observational study was conducted to assess the prevalence of hearing loss in neonates with birth asphyxia admitted to the NICU at KIMS, Hubballi, Karnataka, India, from January 2015 to December 2015. Auditory function was examined by Otoacoustic emission (OAE) followed by auditory brainstem response (ABR) test and distortion product OAE (DPOAE). Statistical analysis, Chi-square test was used and testing data was analysed using the SPSS software version 22. Results: Among the 150 neonates, prevalence of hearing impairment among term neonates with birth asphyxia was 9.9% (14/141). Babies with severe birth asphyxia (P=0.00037), hypoxic ischemic encephalopathy (P=0.00914), convulsions (P=0.0093) and those who were mechanically ventilated (P=0.0003) were more prone to develop hearing impairment. Conclusions: The prevalence of hearing impairment among term neonates with birth asphyxia was 9.9% (14/141). Two staged screening with OAE, which is a feasible screening test in resource poor set up, can be used as a screening modality for hearing impairment in babies with birth asphyxia.

Universal neonatal hearing screening in a tertiary care center in South India

Objective: The aim of the study is to determine the prevalence of hearing loss among newborn infants and to assess the effectiveness and utility of otoacoustic emission (OAE) as a screening tool to detect hearing impairment in newborns and the relationship between selected risk factors and hearing loss. Study Design: This study involved 3121 newborns delivered in a tertiary care center over a 3-year period, who were subjected to distortion product OAE (DPOAE) within 24–72 h of life; failed candidates underwent repeat DPOAE after 30 days. Infants failed the second DPOAE test and then underwent DPOAE and brain stem-evoked response audiometry (BERA) at 3 months of life. Results: 20.95% newborns failed the first screening test, 11.77% failed the second test, and 61.91% of these infants failed the third OAE test. Of the 26 infants who failed the third test, 15 had abnormal results on BERA. Overall, the prevalence of hearing loss was 0.48%. Conclusion: Implementation of a national universal newborn hearing screening program in India is the need of the hour, as early detection of hearing loss will aid early rehabilitation and better outcomes.

Critical appraisal of appropriate method for early detection of hearing impairment in newborns in a tertiary care centre

Background: Hearing plays a vital role in developmental of a child. Hearing loss not only affects the speech and language development of a child but also affects the social, emotional and intellectual development. Hearing is important in the first 2 years of life as this is the critical period for language acquisition. Thereby early detection and intervention for hearing loss is recommended. However, there are no standard protocols for newborn hearing screening. Hence, this study is undertaken to evaluate the appropriate protocol for early detection of hearing impairment in newborns and to ascertain the sensitivity and specificity of Distortion Product Oto-acoustic Emission (DPOAE) and Auditory Brainstem Response (ABR).Methods: A prospective study was conducted in the Department of Paediatrics and Department of Audiology and Speech Pathology in SRM Medical College Hospital and Research Centre. A total of 122 neonates were screened for hearing loss using both DPOAE and ABR before discharge from the hospital. A rescreening with ABR after 1 month was done for those infants who had hearing loss at the initial screening.Results: The study revealed that 16.4% of infants had hearing loss. The referral rate of DPOAE was 54.1% and ABR was 16.4%. ABR had higher passing rates when compared to DPOAE. In a combined screening with both DPOAE and ABR, 17 (13.9%) babies had failed DPOAE with abnormal hearing in ABR (True positives), 49 (40.2%) babies failed DPOAE but had normal hearing in ABR (False positives), 3 (2.5%) babies passed DPOAE but had hearing loss in ABR (False negatives) and 53 (43.4%) babies passed DPOAE and had normal hearing in ABR (True negatives). The association between the results of DPOAE and ABR was statistically significant (0.002). Auditory neuropathy was detected in 3 out of 122 neonates. All these 3 babies belonged to high-risk population. The prevalence of auditory neuropathy is 2.5% which is much lower when compared to other studies. The sensitivity and specificity of DPOAE is 85% and 51.9% respectively. The sensitivity and specificity of ABR was 100%.Conclusions: Present study concludes that the use of combination protocol using both DPOAE and ABR identifies babies with auditory neuropathy spectrum disorder and also ensures high sensitivity and acceptable specificity. Thus, helps in early identification and intervention of congenital hearing loss.

Identification of risk factors for hearing impairment in newborns: a hospital based study.

Aim To identify risk factors for hearing impairment presented in neonates born in Cantonal Hospital Zenica (CHZ) and to estimate their influence on outcome of hearing tests in Newborn Hearing Screening (NHS). Methods Retrospective-prospective study was done at the Department of Gynaecology and Maternity. The NHS was performed with transitory evoked otoacoustic emissions (TEOAE) during a six-month period using "Titan" device (Interacoustics, Denmark). The questionnaire was written for the purpose of getting more structured basic information about every newborn and to identify risk factors for hearing impairment. Chi-square test was used to investigate the difference between experimental and control group refer incidence. Results A total of 1217 newborns was screened for hearing impairment of which 259 (21.28%) with one or more known risk factors for hearing impairment. The following risk factors for hearing impairment were identified during the study period: family history of permanent childhood hearing impairment in 42 (3.45%) newborns, prematurity in 39 (3.21%), low APGAR scores in 29 (2.40%), asphyxia in 31 (2.55%), hyperbilirubinemia in 41 (3.37%), admission of ototoxic medication (aminoglycosides) after birth in 155 (12.74%). Conclusion There were many serious risk factors for hearing loss identified in this study. Identification of risk factors for hearing impairment in neonates is necessary because a follow up of the children with risk factors is very important.

Issues Related to Screening and Caring for Newborns With Hearing Impairments

The critical period for auditory development in humans begins at around the 20th gestational week and continues until 3 years of age. Both genetic and environmental factors are known to cause impaired hearing. Without early identification and intervention, hearing-impaired children face a high risk of experiencing significant difficulties with speech and language development, social behavior, and emotional functioning. Two types of commonly used hearing screening technologies include transient evoked otoacoustic emission (TEOAE) and automated auditory brainstem response (aABR). aABR is considered to have high sensitivity and specificity, to have a relatively low referral rate, and to generate a relatively low rate of false-positive results in identifying newborn hearing impairment. The present paper outlines the psychosocial issues that are commonly experienced by parents of hearing-impaired children. Parents and other family members may benefit from medical, financial, social, and education supports in order to facilitate their adjustment to this challenging situation. The relevant literature is reviewed and recommendations for improving care for this population are provided.

Evaluation of Universal Newborn Hearing Screening with TEOAE-TEOAE and TEOAE-AABR

Introduction : Permanent hearing loss is one of the most common congenital disorders with estimated incidence of one to three per thousand live births. The best early diagnostic method for hearing impairment in newborns is Universal Newborn Hearing Screening (UNHS). This study surveys history of hearing screening, prevalence of hearing loss in newborns and results of various protocol of newborn hearing screening in Varamin city. Materials and Methods : This cross- sectional study was conducted on 29476 neonates with TEOAE-TEOAE (Transient Evoked Otoacoustic Emission-Transient Evoked Otoacoustic Emission) protocol during 1380-1390 years and TEOAE-AABR (Transient Evoked Otoacoustic Emissions-Automated Auditory Brainstem Response) protocol during 1390-1391 years. If the responses in both sessions were desirable, the infants were referred for a final diagnosis with ABR (Auditory Brainstem Response) test and examination by Otolaryngologist. Rehabilitation interventions were done for hearing impaired newborns. Results : The prevalence of hearing loss in first protocol was 1/6 per thousand live births and in second protocol was 2 per thousand live births. 55% of them had risk factors of hearing impairment and 45% of them didn’t have any risk factors. Conclusion : According to the calculated prevalence of hearing impairment in this study, UNHS is necessary for all of newborns and to protect parents from concerns due to a false positive test results, we must improve the method of newborn hearing screening to decrease the false positive rate. Keyword : Hearing loss, Universal newborn hearing screening, Transient evoke otoacoustic emission, Auditory brainstem response