Comparison of Hearing Impairment among Healthy and High-risk Neonates at a Tertiary Care Hospital, Rajasthan, India: A Cross-sectional Study

Abstract

Introduction: Hearing impairment is caused by damage in the inner ear (can be even birth defect), ear infection, ruptured eardrum and so on. It can be prevented using early detection thus, helps in avoiding severe psychosocial, educational, and linguistic repercussions. Infants, who are not diagnosed of hearing impairment before six months of age, will have delays in speech and language development. Aim: To determine the prevalence of hearing impairment in highrisk neonates and to establish the fact that, these neonates have higher prevalence of hearing impairment as compared to normal population. Materials and Methods: A cross-sectional study was conducted in the Department of Paediatrics at Jawaharlal Nehru Medical College and Hospital, Ajmer, Rajasthan, India. The duration of the study was six months, from December 2012 to May 2013. A total of 500 babies including 297 normal and 203 high-risk babies were enrolled into the study. All the neonates were screened using Behavioural Observation Audiometry (BOA) and Distortion Product Oto-acoustic Emission (DPOAE) preferably within three days of life. Those, who failed under this test, underwent for Brain stem Evoked Response Audiometry (BERA). Data was collected in the Microsoft Excel and analysis done by Statistical Package for Social Sciences (SPSS) version 23.0. Results: The mean age of the newborns on admission, was 3.86±4.25 days and the mean weight was 2560±510 g. Out of 500 newborns screened, 58 babies had abnormal results with the first screening test. When these 58 babies subjected to BERA, eight babies showed Hearing Loss (HL). Sepsis, Neonatal Intensive Care Unit (NICU) stay >5 days and use of aminoglycosides >7 days were the important risk factors associated with hearing impairment. Prevalence of hearing impairment in the present study was came out to be 16/1000. This finding was statistically significant with p-value<0.05. Conclusion: There was high prevalence of hearing impairment in high-risk newborns, majority of which were bilateral. The authors recommend multistage screening in all newborns at birth or within month’s time at all level of healthcare facility. Newborns with sepsis, NICU stay >5 days and use of aminoglycosides >7 days should have mandatory audiologic evaluation at discharge.