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Newborn hearing screening: importance and characteristics of a high-risk register in a neonatal intensive care unit

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Abstract

Background

Hearing loss is one of the most common congenital anomalies, occurring in approximately two to four infants per 1000. Children whose hearing loss is identified, and who receive appropriate intervention before 6 months of age, develop significantly better language ability than those who are identified later.

Objectives

To assess the failure rate of neonatal hearing screening in a high-risk register group of neonates and the relative importance of these risk factors in hearing impairment in the neonatal ICU (NICU) of the El-Mounira Children Hospital and identify the incidence of hearing loss.

Patients and methods

The study was carried out on 100 neonates in El-Mounira Children Hospital (NICU) and on 30 control neonates (15 boys and 15girls) chosen from Kasr El-Eini Maternity Hospital. All control cases aged 1–4 days had normal birth weight (2000–4000 g) and gestational age (35–40 weeks) and were delivered normally or by cesarean section without complications. The children in the study group were 3–23 days old (53 boys and 47 girls) and had birth weight ranging from 900 to 4000 g and gestational age ranging from 28 to 41 weeks. All the cases were screened for hearing loss using the transient evoked otoacoustic emission device (Echo-Screen), followed by a second-stage screening for those who failed the test with the transient evoked otoacoustic emission device. Those cases given a Refer were then made to undergo an Automated Auditory Brainstem Response test after 3–4 weeks.

Results

In the NICU group, 55% had hyperbilirubinemia, requiring exchange transfusion, 13% were of low birth weight (<1500 g), and 13% were on mechanical ventilation. Other risk factors such as cranio-facial anomalies showed a combined effect. In the first screening phase, 71% were given a Pass response and 29% were given a Refer response. In the second screening phase, 28% were given a Pass, 31% were given a Refer, and 41% were dropouts, as they had passed their critical stage and had been discharged. The highest referral rates were in neonates with multiple risk factors.

Conclusion

A comprehensive intervention and management program must be an integral part of the screening program in the postnatal period. Public awareness about the value of hearing screening is important for follow-up to be more effective. Monitoring of ototoxic drug administration and further assessment of the high prevalence of hyperbilirubinemia are needed. A team of obstetricians, pediatricians, and audiologists is needed to identify and assess risk factors.

References

  1. Oghalai JS, Chen L, Brennan ML, Tonini R, Manolidis S. Neonatal hearing loss in the indigent. Laryngoscope. 2002; 112: 281–286

    Article  PubMed  Google Scholar 

  2. Delaney AM, Meyers AD Newborn hearing screening 2005. Available at: http://emedicine.medscape.com/article/836646-overview

  3. Parving A. Hearing screening–aspects of epidemiology and identification of hearing impaired children. Int J Pediatr Otorhinolaryngol. 1999;49(Suppl 1):287–292

    Article  Google Scholar 

  4. Korres S, Nikolopoulos TP, Komkotou V, Balatsouras D, Kandiloros D, Constantinou D, et al. Newborn hearing screening: effectiveness, importance of high-risk factors and characteristics of infants in the neonatal intensive care unit and well-baby nursery. Otol Neurotol. 2005; 26: 1186–1190

    CAS  Article  PubMed  Google Scholar 

  5. Mehl AL, Thomson V. Newborn hearing screening: the great omission. Pediatrics. 1998; 101: E4

    CAS  Article  PubMed  Google Scholar 

  6. Allen SG, Bartlett C, Cohen NL, Epstein S, Hanin L, Treni K. Maximizing auditory and speech potential for deaf and hard of hearing children. Hearing J. 1999; 52: 1–14

    Google Scholar 

  7. Hall JW III. Screening for and assessment of infant hearing impairment. J Perinatol. 2000;20(8 Suppl 1):S113–S121

    Article  PubMed  Google Scholar 

  8. Dort JC, Tobolski C, Brown D. Screening strategies for neonatal hearing loss: which test is best? J Otolaryngol. 2000; 29: 206–210

    CAS  PubMed  Google Scholar 

  9. Finitzo T, Albright K, O’Neal J. The newborn with hearing loss: detection in the nursery. Pediatrics. 1998; 102: 1452–1460

    CAS  Article  PubMed  Google Scholar 

  10. Gupta AK, Anand NK, Raj H. Evaluation of risk factors for hearing impairment in at risk neonates by Brainstem Evoked Response Audiometry (BERA). Indian J Pediatr. 1991; 58: 849–855

    CAS  Article  Google Scholar 

  11. Cherow E. Year 2000 position statement: principles and guidelines for early hearing detection and intervention programs. Am J Audiol. 2000; 9: 9–29

    Article  Google Scholar 

  12. Bonfils P, Piron JP, Uziel A, Pujol R. A correlative study of evoked otoacoustic emission properties and audiometric thresholds. Arch Otorhinolaryngol Suppl. 1988; 245: 53–56

    CAS  Article  Google Scholar 

  13. Bener A, Eihakeem AAM, Abdulhadi K. Is there any association between consanguinity and hearing loss. Int J Pediatr Otorhinolaryngol. 2005; 69: 327–333

    Article  Google Scholar 

  14. Levi H, Adelman C, Geal Dor M, Elidan J, Eliashar R, Sichel JY, et al. Transient evoked otoacoustic emissions in newborns in the first 48 hours after birth. Audiology. 1997;36:181–186

    CAS  Article  Google Scholar 

  15. El Danasoury I, Maksoud A, Shalaby A, Nada I Hearing screening: a NICU project. 2003 Audiology Unit, Ain Shams University

  16. Makky S, Rashid E. Hearing screening in Neonatal Intensive Care Unit of Zagazig University Hospitals. Zagazig Univ Med J. 2004. (Special Issue)

  17. El Gamal Y, Hazaa N, Awwaad K, Reda S, Abd-el Halim O. Otoacoustic emission in high risk neonates. Egypt J Otolaryngol. 2001; 185: 145–155

    Google Scholar 

  18. Vohr BR, Widen JE, Cone Wesson B, Sininger YS, Gorga MP, Folsom RC, et al. Identification of neonatal hearing impairment: characteristics of infants in the neonatal intensive care unit and well-baby nursery. Ear Hearing. 2000; 21: 373–382

    CAS  Article  PubMed  Google Scholar 

  19. Haza N, El Danasoury I. Neonatal jaundice: peripheral or central hearing loss? Ain Shams Med J. 1995; 46: 237–242

    Google Scholar 

  20. Jakubíková J, Kabátová Z, Závodná M. Identification of hearing loss in newborns by transient otoacoustic emissions. Int J Pediatr Otorhinolaryngol. 2003; 67: 15–18

    Article  Google Scholar 

  21. Kamal N, El Nekhly I, Kamal R, Hassan D. Neonatal hearing screening: a model for developing countries. Egypt J Pediatr. 2007; 24: 495–509

    Google Scholar 

  22. Swanepoel DW, Hugo R, Louw B. Infant hearing screening at immunization clinics in South Africa. Int J Pediatr Otorhinolaryngol. 2006; 70: 1241–1249

    Article  Google Scholar 

  23. Mukari SZ, Tan KY, Abdullah A. A pilot project on hospital-based universal newborn hearing screening: lessons learned. Int J Pediatr Otorhinolaryngol. 2006; 70: 843–851

    CAS  Article  Google Scholar 

  24. Ferro LM, Tanner G, Erler SF, Erickson K, Dhar S. Comparison of universal newborn hearing screening programs in Illinois hospitals. Int J Pediatr Otorhinolaryngol. 2007; 71: 217–230

    Article  Google Scholar 

  25. Chu K, Elimian A, Barbera J, Ogburn P, Spitzer A, Quirk J. Incidence of newborn hearing loss. Obstet Gynecol. 2003; 101: 584–588

    Google Scholar 

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Correspondence to Tarek Mohamed El Dessouky.

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Farid, A.S., El Salam Seoud, I.A., El Dessouky, T.M. et al. Newborn hearing screening: importance and characteristics of a high-risk register in a neonatal intensive care unit. Egypt J Otolaryngol 28, 17–21 (2012). https://doi.org/10.7123/01.EJO.0000411083.36466.f9

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  • DOI: https://doi.org/10.7123/01.EJO.0000411083.36466.f9

Keywords

  • care unit neonates
  • hearing loss
  • high-risk register
  • hyperbilirubinemia
  • low birth weight-mechanical ventilation-ototoxic drugs
  • neonatal hearing screening
  • neonatal intensive