Newborn Hearing Screening in Prematurity: Fate of Screening Failures and Auditory Maturation

Abstract

Objectives

The purpose of this study was to identify delayed auditory maturation and the fate of premature infants who failed the newborn hearing screening (NHS) in neonatal intensive care unit.

Materials and methods

A total of 1,375 neonates underwent NHS using the transient evoked otoacoustic emission (TEOAE) in a tertiary hospital between 2007 and 2010 according to the Joint Committee on Infant Hearing Guidelines. In addition, a structured telephone survey was given to caregivers of infants who were lost to follow-up NHS. Auditory steady state response (ASSR) threshold and the threshold change of diagnostic test failures were analyzed.

Result

Among the 1,375 NICU babies, 344 (25.0%) babies, 111 (9.7%) babies and 64 (4.6%) babies failed to pass the first TEOAE, second TEOAE and diagnostic ASSR, respectively. However, at the age about five, 12 (0.9%) infants showed permanent hearing loss (PHL). The ASSR threshold improved from 69.0 ± 19.7 dB to 52.9 ± 21.6 dB in < 4 months (p<0.001). Premature infants < 29 weeks of gestational age at birth showed higher referral (p = 0.003) rate at the first OAE test compared to the others, and the difference continued until the last follow up. The odds ratio for the initial ASSR threshold > 67.5 dB for PHL was 9.00 (95% confidence interval, 1.7–46.7).

Conclusion

Most first TEOAE screening failures (91.3%) showed normal hearing and speech development. Hearing levels in premature infants can improve over time, particularly in neonates with initial ASSR threshold < 67.5 dB.

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