Original ArticlesEfficacy of automated auditory brainstem response hearing screening in very preterm newborns☆
Section snippets
Methods
This prospective cohort study was performed in 2 NICUs in the Netherlands from January 1998 to December 1998. All newborns were included after parental consent was obtained. Inclusion criteria were gestational age <32 weeks with or without any of the at-risk criteria according to the JCIH. Exclusion criteria were congenital malformations or syndromal manifestations known to be associated with congenital hearing loss. After birth, AABR hearing screening was performed weekly until a bilateral
Results
AABR hearing screening was carried out in 90 newborns. No children were excluded. The median gestational age was 29.6 weeks (range, 25.1-31.9 weeks), and the median birth weight was 1115 g (range, 600-1960 g). Fig 1 shows the distribution of risk factors according to criteria of the JCIH.First tests were performed 20 times, and second tests were performed 8 times while newborns were receiving ventilatory assistance.
A pass or negative result was
Discussion
In this prospective cohort study, weekly AABR hearing screening showed a pass rate of 80% from 30 weeks’ postmenstrual age on, 90% from 31 weeks on, and a 100% pass rate at 34 weeks’ postmenstrual age in newborns with normal hearing. Gestational age was not a significantly determining factor on pass rates for postmenstrual age.
Neonatal hearing screening is rapidly becoming “standard care” in the United States according to the 1994 JCIH consensus statement.5 The European Consensus Development
References (18)
- et al.
Hearing loss in very preterm and very low birthweight infants at the age of 5 years in a nationwide cohort
Int J Pediatr Otorhinolaryngol
(1993) On estimating survival: a tale of two censors
J Clin Epidemiol
(1989)- et al.
Newborn hearing screening: will children with hearing loss caused by congenital cytomegalovirus infection be missed?
J Pediatr
(1999) - et al.
Sensitivity and specificity of the neonatal brain-stem auditory evoked potential for hearing and language deficits in survivors of extracorporeal membrane oxygenation
J Pediatr
(1997) - et al.
Language of early- and later-identified children with hearing loss
Pediatrics
(1998) Identifying hearing impairment in infants and young children [editorial]
BMJ
(1993)- et al.
The epidemiology of childhood hearing impairment: factors relevant to planning of services
Br J Audiol
(1992) 1994 position statement
ASHA
(1994)Early identification of hearing impairment in infants and young children
NIH Consensus Statement.
(1993)
Cited by (28)
Is antenatal corticosteroids exposure associated with hearing loss in preterm infants? A systematic review and meta-analysis
2023, American Journal of Otolaryngology - Head and Neck Medicine and SurgeryCitation Excerpt :Recent advances in intensive care technology have improved the survival rate of premature infants [4]. However, complications associated with preterm birth, including hearing loss, did not decrease [5,6]. The incidence rate of hearing loss is still varying from 0.2 % to 6.4 % [7].
Maturation of the auditory system in normal-hearing newborns with a very or extremely premature birth
2020, Pediatrics and NeonatologyCitation Excerpt :An automated auditory brainstem response (AABR) hearing screening is advised for screening in the Neonatal Intensive Care Units (NICU) population [Joint Committee of Infant Hearing (JICH) position statement] from 34 weeks' postmenstrual age (PMA) onward.10 However, a longitudinal study among 90 very and extremely preterm babies showed that AABR pass rates of >80% can already be obtained from 30 weeks’ PMA.11 Screening at a relatively low PMA may have the advantage of a low loss to follow-up, but only when the pass rate is sufficiently high.
Limitations and drawbacks of the hospital-based universal neonatal hearing screening program: First report from the Arabian Peninsula and insights
2020, International Journal of Pediatric OtorhinolaryngologyCitation Excerpt :In 1993, the National Institute of Health (NIH) recommended an immediate ABR after a failed initial TEOAE test to reduce the loss to follow up rate at each level because of its high pass rate (96.3%) in comparison to TEOAE (66.7%) when implemented a few hours after birth. Despite its high cost, it is considered the preferred test in cases of early hospital discharge [33–36]. A combination of TEOAE and Automated ABR (AABR) tests as a two-stage screening has been found to have the most favourable combination of specificity, sensitivity, referral rates, and cost-effectiveness [37].
Neurodevelopment outcomes
2020, Environmental Epigenetics in Toxicology and Public HealthNewborn hearing screening at the Neonatal Intensive Care Unit and Auditory Brainstem Maturation in preterm infants
2019, International Journal of Pediatric OtorhinolaryngologyCitation Excerpt :An improper identification and early rehabilitation of hearing loss in infants is known to be responsible for an incomplete/delayed or absent development of speech and language, according to the grade of hearing loss, with negative impact on cognitive development, and with scholastic and social-economic implications [1,15]. The neonatal hearing screening (NHS) protocol for NICU newborns consists in performing a-TEOAE and a-ABR tests, as soon as possible, preferably before discharge [1,16]. a-ABR testing is important in order to identify hearing loss related to auditory neuropathy/dyssynchrony, typically affecting infants in need for NICU care [1,17].
Characterization of newborn hearing screening failures in multigestational births
2018, International Journal of Pediatric OtorhinolaryngologyCitation Excerpt :For children who fail or cannot undergo OAE testing, and for children in whom hearing loss is highly suspected (all NICU infants), auditory brainstem response (ABR) testing is often performed. ABR has limited utility in some pre-term infants, but when performed in infants of at least 34 weeks gestational age, the test has a sensitivity and specificity of 100% and >96%, respectively, making it an ideal test for such studies [7]. The rate of multigestational births (MGB) in the United States is 34.3 births per 1000 [8].
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Reprint requests: H. L. M. van Straaten, MD, Isala Clinic, Location Sophia, PO Box 10400, 8025 AR Zwolle, The Netherlands.