The Effects of Clinical Factors and Neonatal Morbidities on Hearing Screening Among Neonatal Admissions

Abstract

Background: Hearing loss is an important disorder affecting newborns admitted to NICU. A national hearing screening program using otoacoustic emission testing is an essential tool to identify hearing loss early in neonates enabling early intervention to avoid further challenges of pediatric deafness. On the other hand, a delay of the auditory pathway maturation in preterm babies compared to term newborns has already been suggested in the literature. Taking this information into account, in this paper, we aim to identify the best time to perform NICU infant hearing screening tests. Objectives: We aim to study the clinical factors and neonatal morbidities that may affect neonatal hearing screening results using otoacoustic emission test, in order to decrease the false positive test results that increase parental anxiety and increase the need for subsequent investigations. Methods: This is a prospective cross-sectional study that included 204 infants who were admitted to a tertiary referral hospital NICU unit between September 2017 and May 2018. Both transient evoked otoacoustic emissions (TEOAE) and distortion product otoacoustic emission (DPOAE) screening tests were performed in order to screen hearing loss. Results: Our study included 204 infants, 52.9% of which were males and 47.1% females. There were correlations between both hyperbilirubinemia and ventilation ≥5 days and the failure rate of the first OAE test results among NICU infants where the P-values were (p=0.0133) and (p=0.0456) respectively. Moreover, 165 babies (80.9%) passed the first OAE with a mean birth weight of 2759 gram and mean maternal age of 30.6 years, while 39 babies (19.1%) failed the test with a mean birth weight of 2436 gram and mean maternal age of 32 years. There was no statistically significant relation between both maternal age and birth weight with failure of the first screening test. Conclusion: Our study suggests a higher failure rate of the first OAE in NICU infants who had hyperbilirubinemia or ventilation ≥5 days. Therefore, our recommendation is to postpone the first phase of hearing screening for those infants until the first scheduled vaccine appointment to achieve high compliance to attendance and decrease distress to the family that can be associated with false-negative results of the test.