Study On Factors Associated With Hearing Screening Results Among Newborns In Neonatal Intensive Care Unit

Objective To analyze the result of neonatal hearing screening among neonatal Intensive Care units(NICU)and to explore the high-risk factors associated with it.Methods A total of 2678 neonates admitted to NICU in the First Medical Center of Chinese PLA General Hospital were recruited as the screening subjects from January 2015 to December 2020.Distortion Product Otoacoustic Emissions(DPOAE)and Automated Auditory Brainstem Response(AABR)were applied to newborns before discharge for preliminary screening.DPOAE and AABR were also applied to 436 neonates with corrected gestational age of 42 days for secondary screening.The hearing screening results and related high-risk factors were retrospectively reviewed.Results 1.The rate of failing the preliminary screening was 23.49%.And the rates of failing the preliminary DPOAE as well as AABR were 21.62%and 17.20%,respectively.The rates of failing AABR were significantly lower than the that of DPOAE and the combined screening(P<0.05).2.The rate of failing the secondary screening was 17.89%.And the rates of failing the secondary DPOAE as well as AABR were 17.43%and 7.89%,respectively.The rates of failing AABR were significantly lower than the that of DPOAE and the combined screening(P<0.05).3.Further Logistic regression showed that gestational age<28 weeks,birth weight<1500 g,maternal age≥35 years,congenital craniofacial anomalies,and low serum albumin values were main risk factors of preliminary screening.Besides the history of perinatal asphyxia,congenital craniofacial dysmorphisms and higher peak percutaneous bilirubin were main risk factors of secondary screening(P<0.05).Conclusion 1.The rate of failing the preliminary hearing screening in NICU newborns was high,so the combined screening of DPOAE and AABR should be preferred.The two complement each other,which can effectively reduce the false positive rate and false negative rate of hearing screening,avoid missing screening of auditory neuropathy,and improve the accuracy and reliability of hearing screening.2.High-risk factors for the preliminary hearing screening included gestational age<28 weeks,birth weight<1500 g,maternal age≥35 years,congenital craniofacial anomalies,and low serum albumin values.High risk factors for the secondary hearing screening included congenital craniofacial malformations and a history of perinatal asphyxia.