Risk Indicators For Hearing Loss Research Articles

Universal neonatal hearing screening before and during the COVID-19 pandemic.

To verify the frequency of risk factors for hearing loss in newborns and their possible associations with universal neonatal hearing screening results before and during the COVID-19 pandemic. Historical cohort study with data analysis of newborns attended in a reference hearing health service of the Unified Health System (SUS) between January 2017 and December 2021. Those born in 2020 and 2021 were 91% less likely to fail the screening than those born in 2017, 2018, and 2019; therefore, they had a lower percentage of referrals for a retest. There was a decrease in congenital syphilis (1.00%), decrease in HIV (0.95%), and an increase in toxoplasmosis (0.58%) and increase in rubella cases in 2021 in relation to 2017. Syphilis had lower frequency rates during the COVID-19 pandemic (2020-2021). Newborns born in the pandemic year compared to those born pre-pandemic showed a reduction in the presence of two risk indicators for hearing loss and, consequently, a lower chance of failing the UNHS and a lower percentage of referral for retest.

Wideband tympanometry and otoacoustic emissions in children with risk factors for hearing loss

Introduction: Wideband tympanometry and evoked otoacoustic emissions can help audiologically monitor children birth to 3 years old, with or without risk factors for hearing loss. Objective: To study wideband tympanometry results in acoustic absorbance measures and transient evoked and distortion-product otoacoustic emission records during audiological monitoring. Method: This prospective observational study encompassed 58 children with and without risk indicators for hearing loss, with a mean age of 16.7 months. Data were obtained from the databases of four public maternity hospitals in São Paulo. Subjects were characterized as normal hearing or conductive hearing loss in the groups with and without risk factors for hearing loss. Results: Wideband absorbance at 1000 to 8000 Hz was verified to correlate the absorbance level with the transient evoked and distortion-product otoacoustic emission response levels at 1000 to 8000 Hz and wideband tympanometry. Normal hearing individuals’ absorbance at 1500 Hz to 6000 Hz ranged from 0.92 to 0.98, in which the best results may be found. Conclusion: Absorbance values are higher in male and normal hearing children. Evoked otoacoustic emission levels agreed with absorbance measures – the greater the absorbance, the higher the transient evoked and distortion-product otoacoustic emission levels.

Inhibitory effect of contralateral noise on transient otoacoustic emissions in infants with congenital syphilis

ObjectivesAnalyze the inhibitory effect of contralateral noise on transient otoacoustic emissions in infants with congenital syphilis (CS). MethodsCross-sectional study, approved by the Research Ethics Committee n° 3.360.991. Infants with treated CS at birth and infants without risk indicators for hearing impairment were selected. Both groups had the waves I, III and V presence at 80 dB nHL with click BAEP and the presence of response in the nonlinear TEOAEs at 80 dB NPS bilaterally. For suppression, TEOAE were analyzed without the contralateral noise, with the linear stimulus at 60 dB SPL. The neonates who presented a response in three frequencies per ear performed the second TEOAE collection with the contralateral white noise at an intensity of 60 dB SPL. Inferential analysis were performed using the Mann-Whitney and Wilcoxon test, adopting a significance level p < 0.05. ResultsThe sample consisted of 30 subjects divided into two groups, the Study Group (SG), consisting of 16 infants, and the Control Group (CG), consisting of 14 infants with no risk indicators for hearing loss. No differences were observed between the groups and the inhibition values, in the SG 30.8% presented inhibition and 25% for the CG in the right ear, in the left ear it was 46.7% in the SG and 38.5% in the CG. The SG demonstrated greater inhibition in the RE for the frequency bands from 1.5 to 4 KHz. ConclusionsThe analyses adopted in this study point out that the inhibitory effect of contralateral noise on TEOAEs in infants with CS does not differ from infants without risk indicators for hearing loss.

Prevalence of Congenital Infections in Newborns and Universal Neonatal Hearing Screening in Santa Catarina, Brazil.

to verify the frequency of congenital infections in newborns and their possible associations with the universal-neonatal-hearing-screening (UNHS) results, and evaluate a reference UNHS service in the Unified Health System (Sistema Único de Saúde-SUS), according to quality indicators. Historical cohort study with data analysis of newborns attending prestigious hearing-health SUS services from January 2017 to December 2021, in Santa Catarina, Brazil. The quality of screening coverage was assessed based on the quality indicators proposed by the Brazilian neonatal-hearing-screening-care guidelines (Diretrizes de Atenção da Triagem Auditiva Neonatal-DATAN). Logistic-regression analysis, crude OR calculations, Cochran-Mantel-Haenszel OR calculation, and chi-square test were performed to estimate the association between risk indicators for hearing loss and UNHS failure. In the last five years, the prestigious services performed UNHS on 34,801 newborns and met the DATAN quality indicators. Congenital syphilis was the most frequent (1.59%) congenital infection in newborns, followed by HIV (0.87%), whereas the least frequent was rubella (0.029%). Prestigious UNHS services reached ≥95% hearing screening coverage. Considering all congenital infections, the prevalence was 2.87%, with congenital syphilis the most frequent. Newborns with congenital syphilis or HIV are more likely to fail UNHS.

Análise da triagem auditiva de crianças expostas ao vírus Zika

ABSTRACT Purpose: to analyze the results of neonatal hearing screening examinations in newborns with and without microcephaly, exposed to the Zika virus, without other risk indicators for hearing loss, and verify the association between screening results, sample characteristics, and the gestational trimester when exposure took place. Methods: a descriptive cross-sectional study. Subjects included in the study had no risk indicator for hearing loss other than microcephaly, and presented, along with their mothers, positive RT-PCR results, respectively at birth and during pregnancy. The transient evoked otoacoustic emission and brainstem auditory evoked potential examinations were applied by the researcher between March 2016 and December 2017. Newborns failed the screening when they failed at least one retest in at least one ear. The data were descriptively analyzed, using the Fisher exact test; p-values equal to or lower than 0.05 were considered significant. Results: out of the 45 subjects, 30 (66.7%) were females, 6.7% were likely to have sensorineural hearing loss, with or without auditory neuropathy spectrum disorder - which was possibly present in only one ear of one of these three subjects. Failure in the screening was statistically significant in subjects with at least one of the congenital Zika syndrome characteristics and subjects with subcortical calcification and brain cortex thinning, macular chorioretinal atrophy with focal pigmentary mottling, and hypertonia with symptoms of extrapyramidal involvement. The gestational trimester of exposure was associated with screening results. Conclusion: the responses in screening point to the possibility of hearing loss in newborns with and without microcephaly, whereas the presence of microcephaly was not significant to examination failures. Exposure in the first gestational trimester indicated a possible relationship with screening failures.

Association between failure in otoacoustic emissions and risk indicator for hearing loss

ABSTRACT Purpose: to describe the results of a neonatal hearing health program and verify whether there is an association between the presence of risk indicators for hearing loss and failure in the tests and diagnosis. Methods: a one-cohort, observational, retrospective study with secondary data contained in a spreadsheet concerning the family’s sociodemographic condition, clinical history, and examination results of 7,800 participants who were submitted to hearing screening between 2010 and 2016. Absolute frequency and percentages were used in the description of the first and second stages. In the association between risk indicators and failures in the otoacoustic emissions, the odds ratio, confidence interval, and significance level at 0.5% were used. Results: the risk indicators in 8 out of the 12 infants presented with hearing loss were ototoxic medication and intensive care unit (ICU) stay, whereas the likelihood of failure in the otoacoustic emissions occurred along with 11 indicators. The likelihood of a diagnosis of hearing loss was 13 times greater when there was a risk indicator, 18 times greater when an ototoxic medication had been used, and 16.62 times greater when they stayed in ICUs. Conclusion: the results show that knowing the indicators leads to considering the actions the team in charge should take.

Development of infants presented with congenital syphilis in their first months of life

ABSTRACT Purpose: to evaluate the cognitive, language, and motor development of infants with congenital syphilis in their first months of life. Methods: a sample of 52 infants, from 21 to 112 days of age, born in public maternity hospitals, divided into a study group of 28 infants with congenital syphilis and a control group 24 infants without risk indicators for hearing loss. They underwent the Neonatal Hearing Screening Protocol with automated Brainstem Auditory Evoked Potential. The research instrument was the Bayley-III Scale, consisting of the cognitive, language (receptive and expressive), and motor (fine and gross) subscales. The raw scores were entered into the software that accompanies the Bayley-III scale kit to calculate the scores (scaled and composite) and perform qualitative analysis. The Mann-Whitney test and the Wilcoxon test was applied and used a 5% significance level. Results: a similarity between groups for the demographic parameters, maternal education level, and socioeconomic level, was seen. There was no statistically significant difference between groups when comparing the cognitive, receptive language, expressive language, fine motor, and gross motor subscales. Conclusion: infants with congenital syphilis treated at birth have a cognitive, language, and motor development within that expected for their age group in their first months of life.

ANALYSIS OF OTOACOUSTIC EMISSIONS IN NEONATES AT TERM AND PRETERM AT MGMMC, JAMSHEDPUR

The transient evoked otoacoustic emissions (TEOAEs) have been widely used in neonatal hearing screening. OBJECTIVE: To compare the TEOAEs in newborns at term and preterm vis-à-vis the following variables: ear side, gender, frequency spectrum and gestational age. METHOD: By means of 66 newborns up to the 28th day of life (41 newborns at term and 25 premature babies), we recorded TEOAEs. All the individuals did not have risk indicators for hearing loss. RESULTS: There was a signal/noise ratio improvement with frequency increase. No differences were observed between genders and between the ears, but there were differences among the children born at term and preterm in the frequency bands at 3 kHz and 4 kHz. CONCLUSION: The TEOAEs test is important for assessing the peripheral auditory system of newborns at term and preterm, making it possible to have responses regardless of gender and gestational age.

Cognitive, language and motor development of infants exposed to risk and protective factors

IntroductionRisk factors are biological or environmental characteristics increasing the likelihood of delays in child development. Meanwhile, protective factors are conditions that can minimize risks and favor the acquisition of skills. Infants with risk indicators for hearing loss (RIHL) tend to live in less stimulating environments which may lead to lower cognitive, language, and motor development. ObjectiveTo compare the cognitive, language, and motor development of infants under the influence of risk and protective factors. MethodA cross-sectional observational study in which 259 infants aged 8–10 months were assessed for cognitive, language, and motor development using the Bayley Scales of Infant and Toddler Development - Third Edition (BSITD-III). The groups were formed according to the presence or absence of RIHL and the quality of the resources, being: SG-AE (Study Group with Adequate Environment), SG-IE (Study Group with Inadequate Environment), CG-AE (Compared Group with Adequate Environment)) and CG-IE (Compared Group with Inadequate Environment). Affordances were assessed using the questionnaire Affordances in the Home Environment for the Motor Development - Infant Scale (AHEMD-IS). The groups were compared using the Chi-square test or the Kruskal-Wallis test, followed by Dunn's multiple comparison test. The level of significance adopted was 5%. ResultsInfants from the CG-AE performed better than the other groups in cognition and motor skills. The CG-AE language was statistically superior to the SG-IE. SG-IE showed the highest frequency of delays in all domains. CG-IE and SG-AE showed a similar frequency of delays. Adequate environment associated with the absence of RIHL (CG-AE) leads to better cognitive, language, and motor performances. ConclusionBiological and environmental risk factors have a similar impact on development, but the accumulation of both tends to increase the risks of developmental delay. The absence of RIHL and quality environments worked as protective factors and favored the acquisition of skills.

Comparison between click and CE-CHIRP® stimuli in neonatal hearing screening

Objective: To compare the application time of the Automated Auditory Brainstem Response (A-ABR) between the click and CE-Chirp® stimuli.&#x0D; Methods: Forty-six newborns were evaluated without risk indicators for hearing loss and presenting transient evoked otoacoustic emissions (TEOAE). The A-ABR was performed with Interacoustics® Titan equipment in a hospital, with the click and CE-Chirp® stimuli at the same time. Descriptive statistical analyses and inferential statistics analyses (Student's t-test calculation for mean comparisons among independent samples) were used for the variables age, gender, examination time, laterality and test stimulus used.&#x0D; Results: Of the 46 neonates in the sample, 23 were male and 23 female. The mean age of the sample was 23.1 days. The mean procedure time using the Click stimulus was 85.9 seconds for the right ear and 86.1 seconds for the left ear, whereas for the use of the CE-Chirp® stimulus the results obtained for the right and left ear were28.4 seconds and 27.9 seconds, respectively. There was a statistically significant difference between the mean times obtained through the CE-Chirp® and Click stimuli for both ears (p=0.000). There was no statistically significant difference in the comparison between the right and left ears or between females and males.&#x0D; Conclusion: It was found that the mean duration of the A-ABR procedure using the CE- Chirp® stimulus is three times lower than with the Click stimulus.

Electrophysiological Threshold Evaluation in Infants with and Without Risk Indicators for Hearing Loss

Introduction: The brainstem auditory evoked potential is used to determine the electrophysiological threshold and assessing the integrity of the auditory system. This test is sensitive to the auditory nerve maturation and brainstem; therefore, the electrophysiological threshold may change throughout child development. Objective: to evaluate the changes in the electrophysilogical threshold of brainstem auditory evoked potential in two months of follow-up. Methods: A single non-concurrent cohort study was performed in a public hospital during January 2013 to January 2015. The brainstem auditory evoked potential was performed in all neonates in two moments with electrophysiological thresholds measured in the both ears, whose results were categorized into degree: mild, moderate, severe and profound. Results: Forty-three infants of both genders, 11 with prematurity and 14 with risk indicators for hearing loss participated in the study. In the first brainstem auditory evoked potential, with an average age of two months, 34 infants had abnormal results in the right ear and 31 in the left ear. In the second brainstem auditory evoked potential, with na average age of four months, normalization was observed in 38% of the results obtained in the right ear and in 42% on the left ear. This significant change in brainstem auditory evoked potential thresholds was found in those with mild and moderate degrees. Conclusion: There were changes in the electrophysiological brainstem auditory evoked potential thresholds in infants with a mild and moderate degree, while those with a severe and profound degree the results were permanet at two months of follow-up.

Risk indicators for hearing loss and language acquisition and their relationship with socioeconomic, demographic and obstetric variables in preterm and term babies.

To compare the frequency of risk indicators in preterm and full-term babies; to analyze the possible relationships among the presence of risk for hearing loss with language acquisition and socioeconomic, demographic and obstetric variables. This is a longitudinal cohort study, with a sample of 87 babies. Gestational, obstetric and sociodemographic data were collected from mothers and babies. The socioeconomic classification status of the families were classified using the Brazilian Criteria for Economic Classification. The risk for language was assessed using the Language Acquisition Enunciation Signs and the Denver II test. The data were analyzed using the STATISTICA 9.1 software, using the chi-square and the Mann-Whitney U tests and simple and multiple linear regression models. Permanence in a neonatal intensive care (65.52%), ototoxic (48.28%), mechanical ventilation (39.66%) and hyperbilirubinemia (46.55%) were the more frequent risk indicators in the sample. Regarding socioeconomic, demographic and obstetric factors, there was a correlation among prenatal care, gestational age, birth weight, feeding with hearing risk. Acquisition and development of language showed statistical significance with varicella, HIV, Apgar score and birth weight >1500 grams. Preterm babies showed higher frequency of risk indicators compared to full-term babies. Among environmental factors, prenatal care, which interferes in the outcome of gestational age, birth weight, Apgar score and presence of infectious diseases, as well as feeding, emerged as significant factors related to hearing and language acquisition. Prematurity was the relevant biological factor related to hearing and language risk.

Unilateral and asymmetric hearing loss in childhood.

To describe unilateral and bilateral asymmetric sensorineural hearing loss in children and its etiological, audiological and demographic characteristics. Retrospective cross-sectional study developed in the Seção de Implante Coclear of Hospital de Reabilitação de Anomalias Craniofaciais, through the analysis of medical records. Data from 1152 patients were analyzed: 424 (37%) adolescents, adults or elderly, and 728 (63%) children, of whom 691 (95%) had bilateral symmetrical hearing loss, and 37 (5%) had unilateral hearing loss (n=10) or bilateral asymmetric (n=27) sensorineural hearing loss. The mean age at diagnosis of unilateral sensorineural hearing loss was 33.58±21.69 months, and for asymmetric bilateral it was 33.12±21.69 months, with a prevalence of 1.4% and 3.7%, respectively. The highest risk indicator for hearing loss for both groups was the family history of permanent deafness, which began in childhood. The majority of the relatives of children with unilateral sensorineural hearing loss presented the highest low socioeconomic classification (50%), while children with bilateral asymmetric sensorineural hearing loss were also be subdivided into upper (37%) and lower (37%). We observed a greater occurrence of asymmetric bilateral sensorineural hearing loss compared to unilateral hearing loss, as well as the hereditary risk indicator, with a predominance of the deep ear and female preponderance in both groups. Although neonatal hearing screening provides early identification of unilateral sensorineural hearing loss, the age at the audiological diagnosis is still above the recommended level. In addition, the majority of the children's family members presented a low level of income.

Normal Hearing Function in Children Prenatally Exposed to Zika Virus.

Introduction The association between prenatal Zika virus infection and hearing alterations in offspring has been the object of some studies, although few have assessed children without microcephaly. However, a current trend to include prenatal Zika virus exposure in the group of risk indicators for hearing loss is noted. Objective To present a series of 27 children prenatally exposed to the Zika virus submitted to multiple hearing assessments over time. Methods A cohort of children born to symptomatic mothers with laboratorial Zika virus infection confirmation during pregnancy was submitted to an otoacoustic emission test, auditory brainstem response test (automated, neurodiagnostic and frequency-specific), audiometry, and imitanciometry over a period of 36 months since birth. The hearing assessment was performed independently of the presence of microcephaly or other apparent signs of congenital Zika syndrome. Results The hearing tests presented predominantly normal results. Some children had signs of middle ear pathology. The only microcephalic child had normal electrophysiological tests, as well as preserved audiometric thresholds, but presented altered motor responses to sound. Conclusion Prenatal exposure to Zika virus does not always determine hearing impairment. This risk seems to be more associated to the severity of the central nervous system damage. Hearing screening and follow-ups of the affected children are important, as well as further research in this area.

Triagem auditiva neonatal em hospital da Rede Cegonha

Objective: To evaluate the profile of neonates who underwent neonatal hearing screening (NHS) and their mothers in a public hospital linked to the Rede Cegonha program, concerning sociodemographic characteristics and health outcomes. Methods: Cross-sectional, retrospective and documentary study, based on data from medical records of a maternal and child hospital in the city of Porto Alegre, Rio Grande do Sul. The sample consisted of 1,818 mother-baby dyads, who performed NHS from May 2014 to May 2015. The results of the NHS and maternal and neonatal clinical characteristics were analyzed. For data analysis, the statistical program SPSS version 21.0 was used. Results: Of the 1,818 neonates who underwent NHS, 359 (19.74%) had some risk indicator for hearing loss. Neonatal failure in NHS was associated with risk indicators for hearing impairment (presence of congenital HIV, p = 0.035; congenital cytomegalovirus, p = 0.048; and exposure to ototoxic drugs, p = 0.011) and between absence of any risk indicator for hearing impairment with respiratory dysfunction (p = 0.043) and neonatal sepsis (p = 0.021). In neonates without these indicators, this association occurred in those whose mothers had urinary tract infection during pregnancy (p = 0.015). Conclusion: Significant associations were found between NHS failure and maternal and infant characteristics that are not considered as risk indicators for hearing impairment.

Influência do Apgar baixo na primeira triagem auditiva do neonato

Introdução: Diversos são os indicadores de risco para deficiência auditiva. O índice de Apgar, quando menor que quatro no primeiro minuto e/ou menor que seis no quinto minuto de vida, é considerado um indicador de risco para surdez. Tais valores estão associados à ocorrência de asfixia, que é uma das causas mais comuns de lesão e morte celular e, desta forma, algum dano ao sistema auditivo pode ocorrer. Objetivo: Verificar a influência do indicador de risco para deficiência auditiva, Apgar baixo, na primeira avaliação auditiva do neonato. Métodos: Estudo clínico transversal, realizado em hospital público no período de janeiro de 2012 a dezembro de 2016. Os neonatos realizaram a avaliação audiológica por meio do exame de emissões otoacústicas evocadas por estímulo transiente (EOE-t). A relação entre Apgar baixo e “falha” nas EOE-t foi analisada por regressão logística simples. Resultados: Foram avaliados 6.301 neonatos, desses 15,82% (n=996) tinham indicadores de risco para deficiência auditiva e 6,57% (n=415) obtiveram Apgar baixo. Apresentaram falha no exame de EOE-t, uni ou bilateral, 6,5% (n=415) dos neonatos triados. Outros indicadores de risco aumentaram as chances de “falha” na EOE-t, porém o Apgar baixo, isoladamente, aumentou as chances de “falha” em neonatos com peso ao nascimento maior que 1.500 g (OR: 1,58; p=0,02) e sem hemorragia peri-intraventricular (OR: 1,56; p=0,01). Conclusão: O índice de Apgar baixo foi o principal causador de "falha” na primeira avaliação auditiva dentre os neonatos com peso maior de 1.500 g e sem hemorragia peri-intraventricular.

Unilateral Mastication Evaluated Using Asymmetric Functional Tooth Units as a Risk Indicator for Hearing Loss.

BackgroundSome previous studies reported hearing ability can be reduced by impaired masticatory ability, but there has been little evidence reported of an association between hearing loss and unilateral mastication. Therefore, this study aimed to investigate the relationship between unilateral mastication (UM), estimated from individual functional tooth units (FTUs), and hearing loss in a representative sample of Korean adults.MethodsThe analyzed data were obtained from 1,773 adults aged 40–89 years who participated in Korean national survey. Hearing loss was defined as a pure-tone average of >25 dB at frequencies of 0.5, 1, 2, and 4 kHz in either ear. In each subject, UM was calculated as the difference in the sums of the FTU scores, which is an index of posterior tooth occlusion, on the two sides of the oral cavity. The scores were used to classify the UM into low, moderate, and high. The adjusted odds ratios (aORs) and their 95% confidence intervals (CIs) were calculated in multivariable logistic regression analyses.ResultsWhen controlling for sociodemographic factors, the aOR for hearing loss was 3.12 (95% CI, 1.21–8.03) for high UM relative to low UM. This association remained in a fully-adjusted model containing factors related to noise exposure (aOR 2.88; 95% CI, 1.12–7.46).ConclusionAdults with high UM as measured using FTUs showed a higher occurrence of hearing loss than those with low UM.

Hearing of neonates without risk indicators for hearing loss and use of antimalarial drugs during pregnancy: a historical cohort study in the Northern Region of Brazil

IntroductionStudies have demonstrated the ototoxic effects of antimalarial drugs in individuals who receive these drugs, but little is known regarding the toxicity of these drugs in the newborn auditory system when administered to the mother receive the drug during pregnancy. ObjectiveTo verify the incidence of hearing loss in neonates who have no other associated risk indicators, born to mothers treated for malaria during pregnancy. MethodsA retrospective, quantitative cohort study was developed at Hospital de Base Dr. Ary Pinheiro and Clínica Limiar, both located in the municipality of Porto Velho (Rondônia). The sample consisted of 527 newborns divided into two groups: exposed to antimalarials drugs during pregnancy group (n = 32) and non-exposed group (n = 495). Data collection took place from September 2014 to December 2015, through an interview with the mothers and/or guardians of the newborn, through the newborns’ and the mothers’ records, and the neonatal hearing screening database of the above-mentioned institutions. ResultsAll the neonates in the exposed group, assessed through the recording of transient otoacoustic emissions associated with the automated brainstem auditory evoked potential test, underwent neonatal hearing screening in the first examination. Among the newborns in the non-exposed group, 30 showed failure and were retested. Of these, one continued to fail and was referred for diagnosis, in whom the results showed to be within the normal range. Among the neonates of the exposed group, infection with Plasmodium vivax was the most frequent, and was similarly distributed among the gestational trimesters, and chloroquine was the most commonly used antimalarial drug treatment more often given during the third trimester; these findings did not show any influence on the audiological findings of the studied neonates. ConclusionThe present study did not identify any cases of hearing loss in neonates born to mothers who used antimalarial drugs during gestation.

Home environment of infants with risk indicators for hearing loss tends to be less stimulating

ObjectiveTo verify the home opportunities to the motor development offered to infants with and without risk indicators for hearing loss (RIHL). MethodsObservational transversal study was done with infants between 8 and 10 months, being 77 with RIHL (Study Group-SG) and 77 without RIHL (Control Group-CG) The instrument used to characterize the sample and obtain information about the home affordances was the questionnaire Affordances in the Home Environment for the Motor Development - Infant Scale (AHEMD-IS). The results of the AHEMD-IS between the groups were compared using the Mann-Whitney and Chi-Squared tests. The significance test adopted for the study was 5%. ResultsAbsolute values in the frequency of homes considered “moderately adequate” and “less than adequate” were greater in the SG in the most part of the categories, except the item Toys for Fine Motricity. It was possible to observe a statistically significant difference in the Total Score of the groups (p-value = 0.01346). Even with better results when compared with the SG, the number of homes of the CG group with affordances below expected is more than half of the sample. ConclusionsIt was possible to verify that home of infants with risk indicators for hearing loss have statistically less affordances when compared to the homes of infants without the indicators. The results alert us to the need of orientation to the infant's responsible/caretakers regarding to the importance of a favorable environment with stimulation of the infant motor development.

Evasion of Newborn Hearing Screening retest: relation with risk factors for hearing impairment

ABSTRACT Purpose: to analyze the evasion rate of the Newborn Hearing Screening program’s retest, to verify whether the presence of risk indicators for hearing loss influences it, and to describe which risk indicators for hearing loss occur more frequently in these cases. Methods: 1,287 newborns/infants participated, who were screened between June 2015 and June 2018. All of them obtained "fail" as the Newborn Hearing Screening result, were referred to the retest and did not attend it. Information related to the occurrence of risk indicators for hearing loss was observed. Results: the study found that the evasion rate was of 15.23%. The presence of risk indicators for hearing loss did not show an association with non-attendance at this stage of the program (p-value = 0.087). The most frequent indicators in the cases of non-attendance at the retest were: ototoxic medication use and intensive care unit stay for more than five days. Conclusion: high evasion rate of the retest has been observed. It has been found that the presence of risk indicators did not influence the retest evasion rate. Use of ototoxic medication and stay at the intensive care unit were the most frequent indicators among those who did not attend the retest.