Screening for Hearing Impairment in High-Risk Neonates in a Rural Tertiary Care Center

Abstract

Introduction: Among the many congenital problems, loss of hearing is one of the most common treatable diseases. Hearing loss in early life can have deleterious effects on the child's psychosocial, scholastic, and social-emotional development. Aims: The aim of this study was to estimate the incidence of neonatal hearing loss in high-risk neonates admitted in a rural tertiary care center. To determine the risk factors predictive of hearing impairment in these neonates. Materials and Methods: About 200 high-risk neonates were included in the study. The first screening by otoacoustic emission (OAE) was conducted before the neonate's discharge from the hospital. If it failed, OAE was repeated after 4 weeks or at the first immunization visit. If it again failed, then Brainstem Evoked Response Audiometry (BERA) was conducted within no more than 3 months. Statistical Analysis Used: It was performed using IBM SPSS Statistics (IBM SPSS Version 28.0. Armonk, NY). The Chi-square test was used to calculate the P value. P < 0.05 was considered statistically significant. Results: In the initial screening, 49 out of 200 high-risk neonates had referred OAE. Out of 49, 20 failed in repeat OAE. Out of these 20 neonates, hearing loss was confirmed in 15 neonates (7.5%) by BERA. The risk factors most commonly associated with hearing loss in the present study were neonatal intensive care unit admission >24 h (7%), hyperbilirubinemia (3%), meningitis (3%), and ototoxic drugs (3%). In the neonates who had hearing loss (15), 93.33% were having more than one risk factor. Conclusions: Our study concludes that there is significant hearing impairment in high-risk neonates. Screening for hearing loss and early identification is needed to modulate the period of neural plasticity, preventing them to banish into a world of social isolation, and educational malaise. The health-care facilities in rural regions have limited settings. Hence, at least a targeted screening is recommended for early detection of hearing loss and rehabilitation.