Comparison of Newborn Hearing Screening in Well-Baby Nursery and NICU: A Study Applied to Reduce Referral Rate in NICU (original) (raw)
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Annals of Otology and Neurotology, 2019
Aim The aim of this study was to find out the prevalence of hearing impairment in high-risk neonates born in Dr. R.N. Cooper Hospital and H.B.T Medical College and establish the fact that high-risk neonates have higher prevalence of hearing impairment compared with normal population. Materials and Methods A prospective observational study was conducted over a period of 1 year starting from March 2016 and involved three-stage screening of 410 neonates admitted to neonatal intensive care unit of Dr. R.N. Cooper Municipal General Hospital and H.B.T Medical College, Vile Parle (west), Mumbai. All enrolled neonateswere screened by a three-stage screening mechanism. First otoacoustic emission (OAE-1) screening was done within 24 to 72 hours of birth. Parents of neonates referred by OAE-1 were instructed to come back within 28 days for repeat OAE test (OAE-2). Those referred by OAE-2 were asked to come back after further 2 months for brainstem-evoked response audiometry. Data collected in...
Outcomes and Efficacy of Newborn Hearing Screening: Strengths and Weaknesses (Success or Failure?)
The Laryngoscope, 2008
Objective: To assess the outcomes of neonatal hearing screening with regard to the final diagnosis in a very large number of newborns and investigate related strengths and weaknesses of the program. Subjects: In this study, 76,560 newborns were assessed. Method: All neonates were assessed using transient evoked otoacoustic emissions (TEOAEs). Results: From the 76,560 neonates screened, 1,564 (2%) failed the test. According to the screening protocol, all parents of failed neonates were asked to bring their children 1 month following discharge to repeat the test. Of the 541 (34.6%) newborns who repeated the test, 303 (56%) were found normal and 238 (44%) again failed TEOAE. The latter children were referred to two special public centers for full audiology evaluation. In addition, 124 neonates were also referred due to other reasons revealed in the screening process (family history, high levels of bilirubin, etc.). Of the 362 children who were referred to the two special audiology centers, 113 (31.2%) were evaluated by these two centers. In addition, 42 children who had failed initial screening and did not show up for a follow-up appointment to repeat TEOAE were also assessed in the same centers. Of the 155 children who had a special audiologic evaluation, 56 (36.1%) were found to have hearing loss (HL) and 99 (63.9%) normal hearing. In detail, 28 had bilateral sensorineural HL greater than 40 dB, 10 had unilateral sensorineural HL greater than 40 dB, and 18 had otitis media with effusion or other conductive HL. Conclusions: Derived from the present study: 1) repeated testing of "failed" newborns in the maternity hospital and before discharge leads to an acceptable referral rate of 2%; 2) the 1-month follow-up of "failed" newborns further limits the false positive results but leads to high rate of newborns lost to follow-up; 3) a dedicated secretariat system should be implemented to follow-up each "failed" newborn and remind parents about their follow-up appointments; and 4) additional measures such as detailed educational material and parental friendly approach should also be implemented.
Neonatal Hearing Screening: The Importance of the Study of Risk Indicators for Hearing Loss
Journal of Otolaryngology-ENT Research, 2017
Objective: to analyze the frequency of risk indicators for hearing loss and its influence on the increase number of refer cases. Methodology: The study was carried out in a public hospital with a sample of 796 infants who participated in the neonatal hearing screening program by transient evoked otoacoustic emission (TEOAE). Results: 132 (16%) newborn had some risk indicators for hearing loss. NICU stay, low Apgar score, mechanical ventilation, lower birth weight less than 1500g and use of ototoxic drugs were the most frequenty risk indicators. A total of 51 (6%) newborns refer in the TEOAE test in at least one ear, and among them, 16 (31%) had a risk indicator for hearing loss. There was a statistically significant relationship between the refer rates in TEOAE with the following risk indicators: craniofacial malformation, genetic syndrome and birth weight less than 1500g. Conclusion: The NICU stay, low Apgar score, mechanical ventilation, birth weight less than 1500g and use of ototoxic drugs were the risk indicators most frequenty in this sample and the main risk indicator associated with refer in the TEOAE teste were craniofacial malformations, genetic syndromes and birth weight less than 1500g.
Universal Neonatal Hearing Screening: An Experience at Tertiary Care Hospital
Kathmandu University Medical Journal, 2020
Background Hearing loss among neonates is one of the important health issue in pediatric population which may remain unnoticed until the child reaches a certain age. The importance of universal early screening, diagnosis and intervention in reducing the negative impact of congenital hearing loss has been described all over the world. Objective To observe the outcome of hearing screening by Automated Auditory Brainstem Response (AABR) in newborns delivered in Dhulikhel Hospital and neonates admitted in an intensive care unit (NICU) of Dhulikhel Hospital. Method A prospective study was done in neonates who were born at Dhulikhel Hospital, Kathmandu University Hospital from February 15th, 2017 to October 30th, 2019. AABR was used for their hearing assessment within 24 hours of birth and again at about 6 weeks of age in those neonates who failed the initial test. All the neonates admitted in NICU were studied regarding the risk factors based on Joint committee on Infant Hearing. Those w...
TAJ: Journal of Teachers Association
Introduction: One to three per 1,000 live births suffers from significant hearing impairment. However, 2 to 4 per 100 infants who survived neonatal intensive care have some degree of sensorineural hearing loss. If hearing impairment in newborns is detected earlier, early management can prevent undesirable and often irreversible damage due to late detection. Early detection and the treatment of hearing impairment in children are essential for the development of communication skills, social skills, emotional well-being, and positive self-esteem. Unfortunately, this disability remains undetected for many newborns until it is too late to prevent undesirable and often irreversible damage. Unfortunately, not many studies were done on this topic in Bangladesh. The magnitude of the burden of hearing impairment in the study place might be identified by this study. The objective of the study: Hearing screening was done to see the status of hearing impairment in newborns admitted to NICU. Me...
Prevalence of hearing impairment among high risk neonates-A hospital based screening study
Background and objectives: Hearing loss present at birth is one of the major disabilities in childhood, the early detection of which can prevent further disability in speech, language and cognition. The prevalence of congenital hearing loss has been estimated to be 1.2 – 5.7 per thousand live births and is more among high risk neonates. In this context the present study was conducted as an attempt to find the prevalence of hearing loss among high risk neonates and the associated risk factors. Methodology: The present study was a hospital based cross sectional study conducted at a tertiary care centre in Trivandrum, Kerala during the period of November 2012 to October 2014. A total of 231 high risk babies were assessed by 2 staged DPOAE screening and those who failed the second stage DPOAE screening were subjected to diagnostic Brainstem Evoked Response Audiometry. Results: 0.9% of the high risk babies had hearing loss. Both the neonates who had sensorineural hearing loss were males and had identifiable risk factors, such as hyperbilirubinemia, ototoxicity, neurological deficits and congenital malformation. Conclusion: The two staged screening protocol with Distortion Product Otoacoustic Emission and confirmation by Brainstem Evoked Response Audiometry was found to be a useful tool in detecting hearing loss in newborn. Hence the results of this study will be used to initiate universal newborn hearing screening in our hospital. Moreover our study highlights the relevance of neonatal hearing screening in our country where this screening is not performed routinely in all hospitals.
Newborn Hearing Screening and Early Diagnostic in the NICU
BioMed Research International, 2014
The aim was to describe the outcome of neonatal hearing screening (NHS) and audiological diagnosis in neonates in the NICU. The sample was divided into Group I: neonates who underwent NHS in one step and Group II: neonates who underwent a test and retest NHS. NHS procedure was automated auditory brainstem response. NHS was performed in 82.1% of surviving neonates. For GI, referral rate was 18.6% and false-positive was 62.2% (normal hearing in the diagnostic stage). In GII, with retest, referral rate dropped to 4.1% and false-positive to 12.5%. Sensorineural hearing loss was found in 13.2% of infants and conductive in 26.4% of cases. There was one case of auditory neuropathy spectrum (1.9%). Dropout rate in whole process was 21.7% for GI and 24.03% for GII. We concluded that it was not possible to perform universal NHS in the studied sample or, in many cases, to apply it within the first month of life. Retest reduced failure and false-positive rate and did not increase evasion, indic...
Neonatal screening for hearing loss: pilot study from a tertiary care centre
Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India, 2009
Many developed countries have well established universal neonatal hearing screening programs. In India, the viability of such a program, in an already overburdened health system is indeed a challenge. This cross sectional study was undertaken to evaluate the possible burden of hearing loss among neonates born at a tertiary care hospital in Southern India. Five hundred neonates were screened with automated distortion product otoacoustic emission (aDPOAE) for hearing loss, 9.2% of whom had one or more high risk factors. Although 6.4% had hearing loss at initial assessment, only 1.6% had hearing loss on retesting with aDPOAE. Retesting with OAE before an automated Auditory brainstem response (aABR) helped to exclude patients without hearing loss. The frequency of moderate to moderately severe hearing loss in this study was 0.6%. This pilot study underscores the importance of the introduction of screening for congenital deafness in specialized centers in India, despite its challenges.
Evaluation of 1808 Newborns Hearing Screening Outcome
2018
Objectives: We evaluated the results of hearing screening tests performed at our center during the study. Methods: In this descriptive study, 1808 newborns at our center between October 2015 and November 2017 were examined. Hearing screening tests were done according to the National Hearing Screening Protocol without discharge from the baby hospital. Results: In this study totally 1808 babies were designated for hearing screening test. According to the hearing screening tests, the percentage of babies who are suspected of hearing loss and referred to the reference center is 0.11%. Conclusion: Early detection of hearing the loss in newborns is important for early treatment. All newborns should be assessed in terms of their risk factors and all those involved in the risk group should be screened. In this respect, treatment of hearing loss children can be started for language and speech development can be achieved.