Results Of Newborn Hearing Screening Research Articles

Methods of Tracking Newborns: New York State Zika Pregnancy and Infant Registry, 2015-2017.

Objectives. To describe methods employed to track infants enrolled in the New York State Zika Pregnancy and Infant Registry (NYSZPIR) and demonstrate the benefits of population databases to improve the process.Methods. We used patient medical records and provider outreach, New York State Immunization Information System (NYSIIS), and New York State Early Hearing Detection and Intervention Information System (NYEHDI-IS) to gather medical information. We used descriptive statistics to summarize variables and the McNemar test to determine statistical significance (P < .05).Results. We identified 109 live births from NYSZPIR mothers. Provider information was documented for 106 (97.2%) infants in NYSIIS compared with 72 (66.1%) through chart review. Collected results of newborn hearing screening increased from 82 (75.2%) to 106 (97.2%) using NYEHDI-IS. The amount of data obtained was significantly higher (P < .001) when including NYSIIS and NYEHDI-IS compared with using medical records alone.Conclusions. Public health surveillance systems can be used to track infants using data sources such as NYSIIS and NYEHDI-IS in addition to traditional methods. Using medical records alone is inadequate for locating and tracking infants and may result in high lost to follow-up rates.

Does an early discharge of a newborn influence the success of the newborn hearing screening in developing countries? A hospital based study.

Aim To investigate outcomes of newborn hearing screening (NHS) with transient evoked otoacoustic emissions (TEOAE) depending on the time from the birth to hearing screening. Methods A prospective study was performed in the Cantonal Hospital Zenica, Bosnia and Herzegovina. The NHS with TEOAE was done before hospital discharge for all infants. The total of 1217 newborns were tested during a six-month period, from 1st February to 31st July 2016. The data of 1167 were available for analysis. Those data were divided in four groups depending on the time passed from the birth to hearing screening: Group A (n= 133 newborns, NHS performed in the first 24 hours after birth); group B (n = 294 newborns, NHS performed between 24-36h after birth); group C (n = 184 newborns, NHS performed between 36-48h after birth) and group D (n= 556 newborns, NHS performed later than 48h after birth). Results Total referral rate was 19.1% (n = 223): for group A 30.1% (n=40), for group B 25.2% (n=74), for group C 19.0% (n=35) and for group D 13.3% (n=74). There was statistically significant difference between groups A and C (p=0.03), between groups A and D (p<0.001) and between groups B and D (p<0.001) in total and in well baby nursery (WBN). Conclusion The total referral rates in NHS were high because of early post birth discharge of newborns. The NHS should be performed in infants older than 36 hours according to the results in this study.

Retrospective Evaluation of Results of Newborn Hearing Screening and Importance of Patient Record System

Objective The aim of the present study was to evaluate hearing screening results of 3490 newborns who underwent newborn hearing screening between 2015-2017 in Cumhuriyet University Faculty of Medicine Department of Otolaryngology, to asses deficiencies of our record system, and to share our retrospective results by comparing with the results in the literature. Material and Method Hearing screening results of infants who were born in Cumhuriyet University between March 2015 and February 2017, were referred to neonatal intensive care or transferred from other out-of-town or inner city hospitals to our university was retrospectively evaluated in the present study. Results There was a statistically significant difference for the left ear TEOAE test results and gender (p<0.05, p=0.016, x 2 =5.78). And also summarizes the distribution of ABR test results in terms of gender while failure rate was statistically significant in the right ear in terms of gender (p<0.05, p=0.022, x 2 =1.33). Conclusion When results of the present study were evaluated, it was found that while they were similar to some results in the studies on this issue in the literature, they showed great differences than some of them. Our main goal was to evaluate insufficiencies in record systems of both our hospital and external centers while we were planning the present study. Our results revealed that these records were not paid enough attentions at external centers and our record system had some insufficiencies.

Improving universal newborn hearing screening outcomes by conducting it with thyroid screening

ObjectivesOne of the most important factors that can improve hearing screening indicators is testing infants after 48 h of birth. The neonatal thyroid screening program is done during the third to fifth day after birth in many countries. So this screening is done at the appropriate time for hearing screening. The aim of the present study was to evaluate hearing screening outcomes (the referral rate, false positive rate, and positive predictive value) conducted with the thyroid screening at the healthcare centers and compare the results with hospital before discharge the infant. MethodsThis was a prospective exploratory cohort study. The study population included all the newborns at a hospital (group 1) and newborns who were referred to healthcare centers for thyroid screening (group 2), except for infants with risk factors, from March 2012 to December 2017. Transient evoked otoacoustic emissions (TEOAE) and automatic auditory brainstem response (AABR) were used for the evaluation. The results were compared between the two groups. ResultsOf the 4729 newborns, who participated in the study, 3001 were referred from a hospital (group 1) and 1728 from two healthcare centers (group 2). The referral rate in group 1 and 2 was 16.1% and 7.6%, respectively. Also, the false positive rate in group 1 and 2 was 15.9% and 7.6%, respectively. Our study showed that the referral rate and false positive rate of hearing screening in group 2 were significantly lower than that in group 1 (p < 0.001). The positive predictive value in group 1 was significantly higher than that in group 2 (p < 0.05). There was no significant sex difference in any of the variables. ConclusionsOur results showed that performing the hearing screening during the thyroid program, instead of the hospital could be significantly improved screening outcomes and suggest that hearing and thyroid screening together after discharge from the hospital could be a good opportunity to introduce new framework for hearing screening in many countries.

The follow-up results of newborn hearing screening of Gaziosmanpasa Taksim Research and Training Hospital.

This study aimed to present the results of newborns who were referred to advanced audiology centers after newborn hearing screening, and to determine concordance of our results with the American Academy of Pediatrics guidelines about the ages of hearing loss, aid fitting, and cochlear implantation. A total of 7502 newborns were screened in Gaziosmanpaşa Taksim Research and Training Hospital between March 2014 and June 2016 using the transient otoacustic emissions test as the first two steps and automated auditory brainstem response test for the third step. Newborns who had risk factors were screened using the automated auditory brainstem response only. Newborns who failed the screening tests were referred to advanced audiology centers. Of the 7502 newborns, 6736 (90%) completed the screening. The ratio of hearing loss was 0.08%. Six of 62 newborns who failed auditory brainstem response test and were referred to advanced audiology centers had severe bilateral hearing loss. One of the patients was not fitted with a hearing aid because the family refused it. The other one was not fitted an aid and did not undergo cochlear implantation because of severe and treatment-resistant acute otitis media. The age of diagnosis for the rest was before three months, and except for one patient, hearing aid fitting was before six months. The age of cochlear implantation was 12 months for two patients and 14 months for two patients. Ninety percent of patients completed the screening, the age of diagnosis for hearing loss was before three months and aid fitting was before six months, except for one patient. The results of the study were compatible with the diagnosis and treatment guidelines of the American Academy of Pediatrics.

Population-based cross-sectional study to assess newborn hearing screening program in central Germany

ObjectivesEarly diagnosis of congenital hearing loss is fundamental to minimize the negative consequences on the speech development. To lower the age at diagnosis and at intervention in hearing impaired children, not only universal newborn hearing screening (NHS) but also tracking is considered essential. The aim of the study was to evaluate the first six years after implementation of the population based newborn hearing screening program in Saxony-Anhalt, one German Federal State. MethodsThe cross-sectional cohort study consisted of three cohort samples. Overall 102,301 infants born between January 2010 and December 2015 were included. NHS protocol was developed as dual target group protocol with two sub-protocols. The screening technique included Transient Evoked Otoacoustic Emissions (TEOAE) and Automated Auditory Brainstem Response (AABR) test. Newborns were assigned to the sub-protocols according to their audiological risk factors. Additionally, to evaluate the quality of NHS and tracking (false-negative screening) we were analysing data from a cohort of hearing impaired children diagnosed up to the age of three years. We calculated quality indicators and compared them with international guidelines. Results101,102 (98.8%) infants were screened. The prevalence of bilateral neonatal hearing loss was 2.32 per 1,000 newborns. The median age was two days at first screening, three month at diagnostic testing, and four month at intervention onset. 2.6% infants were lost to follow-up. 56.3% had a final diagnosis of bilateral sensorineural hearing loss. The sensitivity of 0.85 (KI 95%: 0.76-0.91) and a specificity of 0.84 (KI 95%: 0.84–0.85) was calculated for the NHS program. ConclusionThe analysis of benchmarks and outcomes of NHS demonstrated that the program reaches its main goal to identify the hearing impaired newborns in a timely manner.

Maternal Emotional Reactions towards Results of Newborn Hearing Screening: A Cross Sectional Survey

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The results of newborn hearing screening by means of transient otoacoustic emissions – has anything changed over 10 years?

ObjectivesUniversal newborn hearing screening (UNHS) has become the standard of care in many countries. The aim of this study was to evaluate the results of UNHS after ten years of the program in Poland and to compare them with the results of 2003. MethodsIn the study, we analyze the results of UNHS in the University Hospital in Poznan, Poland. Between 01.01.2013 and 31.12.2013, 6827 children were examined by means of otoacoustic emissions. ResultsRisk factors (RF) were identified in 772 (11.3%) newborns, which is significantly less than 10 years ago (p < 0.05). The most frequent RF were: ototoxic medications, treatment in neonatal intensive care unit (NICU) and prematurity < 33 weeks of gestation. In 2003, the most frequent were ototoxic medications and prematurity, less frequent was treatment in NICU and more common was low Apgar score.In 51 (6.6%) newborns with RF, the result of OAE was positive either unilaterally or bilaterally. In infants without RF the result was positive unilaterally in 22 (0.4%) and bilaterally in 14 (0.2%) patients. These results are significantly lower than in our former study.The relative risk of positive result was the highest in infants with complex congenital anomalies (RR = 44.99), craniofacial anomalies (RR = 17.46) and mechanical ventilation for > 5 days (RR = 10.69). In our previous study, the highest RR of positive test results was in infants with family history, congenital malformations and low Apgar score.We found that most predictive as to the final diagnosis was bilaterally positive OAE test. In most patients, the second check confirmed the diagnosis, independently of RF.The number of false positive tests at the 1st level of screening is significantly lower now than 10 years ago, probably due to better staff training. ConclusionsLong term monitoring and the appropriate management of hearing deficit in children is essential. UNHS seems to be the most efficient way of finding children who require treatment of hearing impairment. The prevalence of most risk factors of hearing deficit has significantly changed over the years. The number of false positive results has significantly decreased over the years thanks to better staff training.

Health Vulnerability Index and newborn hearing screening: urban inequality.

To analyze the intra-urban differentials related to the outcome of the Newborn Hearing Screening (NHS) of children living in Belo Horizonte tested in a reference service using the Health Vulnerability Index (HVI). cross-sectional study with children living in Belo Horizonte evaluated by a Newborn Hearing Screening Reference Service (NHSRS) between 2010 and 2011. The HVI of the census tract of each child was obtained by the georeferencing of their respective addresses. Multivariate analysis was conducted using the decision tree technique, considering a statistical model for each response. A thematic map of points representing the geographic distribution of the children evaluated by the NHS program was also developed. The NHS failure rate for children living in areas with very high HVI, or without HVI data, was 1.5 times higher than that for children living in other census tracts. For children living in areas of low, medium, and high HVI, who underwent NHS after 30 days of life, the NHS failure rate was 2.1 times higher in children that presented Risk Indicator for Hearing Loss (RIHL) (17.2%) than in those who did not (8.1%). Uneven distribution was observed between areas for children that underwent the NHS and those who failed it. Significant intra-urban differentials were found in Belo Horizonte, indicating correlation between health vulnerability and NHS outcomes.

Newborn hearing screening in Queensland 2009-2011: Comparison of hearing screening and diagnostic audiological assessment between term and preterm infants.

This study compares rates and timing of newborn hearing screening outcomes, audiological assessment and hearing loss diagnosis between infants of different gestational age groups. Early identification and management of sensorineural hearing loss (SNHL), ideally by 3-6 months of age, facilitates speech and language optimisation. Literature stratifying hearing screening and diagnostic audiology assessment by gestational age groups is lacking. Subjects were infants with recorded gestational ages receiving newborn hearing screening in Queensland between 2009 and 2011. Data were provided through the Queensland Healthy Hearing database. Infants were analysed in <34 weeks, 34-36+6 weeks, 37-38+6 weeks and ≥39 weeks gestational age groups. Infants (175 911) were eligible for analysis, 7.9% being preterm. Per 1000 infants analysed, bilateral SNHL of >40 dB occurred in 2.4 for <34, 1.4 for 34-36+6 , 0.7 for 37-38+6 and 0.7 for ≥39 weeks gestation. Diagnoses attributable to newborn hearing screening direct referral were 93.1% for bilateral >40 dB SNHL and 88.2% for other hearing loss. Relative to term, preterm infants had a higher incidence of direct and targeted surveillance referrals, audiology assessment and hearing loss diagnosis. Preterm infants were screened later after birth. Specific hearing screening and diagnosis characteristics differed between preterm infants <34 and 34-36+6 weeks gestation, and term infants. Consideration of unique gestational age strata characteristics supports care individualisation. Preterm infants represent a diagnostic challenge, with higher rates of bilateral >40 dB SNHL than term but correspondingly higher false positive results on screening, justifying vigilant monitoring. Focused research into specific risk factors in preterm infants is warranted.

Muğla Sıtkı Koçman Üniversitesi Eğitim ve Araştırma Hastanesi Yenidoğan İşitme Taraması Sonuçları

Objective: The patients with congenital hearing loss can diagnosed and treated early with newborn hearing screening programs. The aim of this study was the evaluation of the newborn hearing screening outcomes at Mugla Education and Research Hospital and to compare the results with recent literature. Material and Methods: Infants who underwent hearing screening between January 2011 and December 2015 at Mugla Education and Research Hospital were included in the study. The newborns, with no risk factors, were screened using transient evoked otoacoustic emissions (TEOAE). The newborns who failed the first screening were tested again after one week with the TEOAE. The infants who failed the test twice and were under high risk were screened using Auditory Brainstem Response (ABR). If the infants failed to pass ABR screening they were referred to tertiary health center. results: A total of 6724 babies were tested in five years. There were 16 patients in 2011, 15 patients in 2012, 10 patients in 2013, 8 patients in 2014, and 14 patients in 2015 for a total of 63 (0.93%) patients referred to a tertiary center with a preliminary diagnosis of hearing loss. Seventeen patients (0.25%) were diagnosed with permanent hearing loss. Fifteen patients (0.22%) had bilateral and two (0.02%) had unilateral hearing loss. conclusion: Early diagnosis and rehabilitation of congenital hearing loss positively affects the language development and cognitive functions of the individuals. Therefore, it is very important to put effective hearing screening programs into practice. Testing with the combination of TEOAE and ABR reduce unnecessary referrals to the tertiary hearing center. ABR test is more useful than TEOAE in high-risk groups.

Usefullness of 1000 Hz Tympanometry in the Results of Newborn Hearing Screening

Usefullness of 1000 Hz Tympanometry in the Results of Newborn Hearing Screening

Neonatal hearing screening in a low-risk maternity hospital in São Paulo state

IntroductionThe literature indicates that neonatal hearing screening should be universal, so a description of programs that adopt this recommendation is relevant. ObjectiveTo describe the results of newborn hearing screening and the profile of mothers and newborns attended to in a low-risk maternity setting, and to correlate the characteristics of this population with the results of transient evoked otoacoustic emissions. MethodsA contemporary cross-sectional cohort study. The sample consisted of 670 infants and the procedures performed were audiological history, transient-evoked otoacoustic emissions (TEOAE), distortion product-evoked otoacoustic emissions (DPEOAE), and automated-brainstem auditory evoked potential (ABSAEP). ResultsThe rate of success in this program was 98.5%, the failure rate was 0.62%, and that of non-attendance to finalize the diagnostic process, 0.93%. When correlating the variables studied with the results of transient evoked otoacoustic emissions, there was a significant negative correlation only for age of infant. ConclusionThe program of this maternity hospital was effective and complies with national and international recommendations. The population consisted of young mothers with few pregnancy complications and healthy infants. The only variable that influenced transient evoked otoacoustic emission results, after hospital discharge, was the age at which infants were evaluated.

Newborn hearing screening outcomes during the first decade of the program in a reference hospital from Turkey.

In this study, the authors report the results of a three-stage newborn hearing screening (NHS) program for well babies at the Gazi University Hospital (GUH) in Ankara between 2003 and 2013. GUH-NHS was performed by automated transient evoked otoacoustic emission (a-TEOAE) at the first and second steps and by automated brainstem audiometry (a-ABR) at the third step. The data were analysed to assess not only rate of congenital permanent hearing loss (CPHL), but also the effectiveness of the program during the years. A total of 18,470 well babies were tested. The data showed that coverage ratio for the GUH-born babies was increased and more outside-born babies (OBB) were admitted by time (means 84.31 and 11.28 %, respectively). Mean CPHL was found to be 0.26 %. Mean referral rate was decreased to 0.81 % by a-ABR from 2.16 % by a-TEOAE. Mean of missed cases in any stage of GUH-NHS was 4.88 %. It was seen that neither CPHL nor referral rate, but only ratio of missed ones presented increase in parallel to increment in OBB. This paper first presents that clinically acceptable screening procedures developed in GUH by time, and secondly higher rate of CPHL in Turkey than in the Western countries, and benefits of third stage screening by a-ABR because it prevented referral of 251 children (1.29 %) to the clinical tests. We think that this number is reasonably important regarding not only economical point of view, but also waiting lists in the audiology departments in a developing country, in which audiological service is still limited.

Outcomes with OAE and AABR screening in the first 48 h—Implications for newborn hearing screening in developing countries

ObjectiveEarly discharge of newborns (<24h after birth) from birthing centres is an important barrier to successful newborn hearing screening (NHS) in developing countries. This study evaluated the outcome of NHS within the first 48h using an automated auditory brainstem response (AABR) device without the need for costly disposables typically required, and transient evoked otoacoustic emissions (TEOAE). MethodsNHS was performed on 150 healthy newborns (300 ears) with TEOAE and AABR techniques before discharge at a hospital. A three-stage screening protocol was implemented consisting of an initial screen with TEOAE (GSI AUDIOscreener+) and AABR (BERAphone® MB 11). Infants were screened at several time points as early as possible after birth. Infants were only re-screened if either screening technique (TEOAE or AABR) initially yielded a refer outcome. The same audiologist performed all TEOAE and AABR screenings. ResultsOver the three-stage screen AABR had a significantly lower refer rate of 16.7% (24/144 subjects) compared to TEOAE (37.9%; 55/145 subjects). Screening refer rate showed a progressive decrease with increasing age. For both TEOAE and AABR, refer rate per ear screened 24h post birth was significantly lower than for those screened before 24h. For infants screened before 12h post birth, the AABR refer rate per ear (51.1%) was significantly lower than the TEOAE refer rate (68.9%). Overall AABR refer rate per ear was similar for infants screened between 24 to 36h (20.2%) and 36 to 48h (18.9%) but significantly lower than for TEOAE (40.7% and 41.9%, respectively). Lowest initial refer rates per ear (TEOAE 25.8%, AABR 3.2%) were obtained after 48h post birth. ConclusionIn light of the early post birth discharge typical in developing countries like South Africa, in-hospital screening with AABR technology is significantly more effective than TEOAEs. AABR screening with a device like the MB 11 is particularly appropriate because disposable costs are negligible.

Influence of Gestational Malaria on the Results of Newborn Hearing Screening

Influence of Gestational Malaria on the Results of Newborn Hearing Screening

Influence of Maternal Socioeconomic and Demographic Aspects in the Results of Newborn Hearing Screening

Influence of Maternal Socioeconomic and Demographic Aspects in the Results of Newborn Hearing Screening

Assessment of Conductive Dysfunction: Wideband Acoustic Immittance

The conductive mechanism plays an important role in our hearing: the first stage of signal processing in the auditory system. While it consists of the ear canal, the crucial portion is the middle ear system, which transforms airborne sound into mechanical vibration and helps improve sound transmission into the fluid-filled inner ear. Hearing loss due to dysfunction of the middle ear system may be threatening to the quality of life for humans. For example, conductive hearing loss may significantly impact normal speech and language development of children. Assessment of middle ear dysfunction is essential for audiological diagnosis of hearing loss and differential diagnosis of ear diseases. For instance, middle ear dysfunction may cloud outcomes of newborn hearing screening. Acoustic immittance is the current clinical technique for assessment of middle ear dysfunction. The major procedures include tympanometry and acoustic reflex test. In these procedures, a single-frequency probe tone (e.g., 226 Hz and 1000 Hz) is used to estimate the acoustic impudence/admittance of the middle ear. Although they have been a clinical routine in audiology since 1970s, value of these procedures in assessment of conductive dysfunction has been limited.

Newborn hearing screening in neonates exposed to psychoactive drugs.

Introduction In pregnancy, the mother and fetus share body structures based on the maternal organism. Exposure to psychoactive drugs in this period may have repercussions on the baby's hearing. Therefore, it is necessary to investigate this association. Aim Analyze the results of newborn hearing screening (NHS), the occurrence of associated risk factors, and the incidence of hearing loss in newborn exposed to psychoactive drugs during pregnancy. Methods This is an observational retrospective study done from a database analysis. From this database, records were selected about the use of psychoactive drugs by mothers during pregnancy, then the neonates were divide into two groups: the study group (146 babies exposed to drugs) and the control group (500 babies not exposed to drugs). The NHS failure rate, the presence of risk factors for hearing loss, and need for audiological diagnosis were analyzed in both groups. From these variables, absolute frequency and prevalence rates were calculated and the results compared between groups. Results There was no statistically significant difference in the comparison of NHS failure rates between the groups (p = 0.267). The occurrence of risk factors for hearing loss was greater in babies exposed to drugs (p < 0.0001). There was only one diagnosis of hearing loss, which occurred in the control group (p = 0.667). Conclusion The use of psychoactive drugs by mothers during pregnancy did not affect the NHS failure rate of this sample. However, the occurrence of significant risk factors in the study group showed a possible sensitivity of babies exposed to psychoactive drugs during pregnancy.

Newborn Hearing Screening Outcomes at Istanbul Education and Research Hospital

Newborn Hearing Screening Outcomes at Istanbul Education and Research Hospital