Study on factors associated with hearing screening results among 1 300 newborns in neonatal intensive care unit

Objective To analyze the hearing screening results among newborns in the neonatal intensive care unit (NICU),and to explore factors associated with it.Methods 1 300 newborns admitted to NICU in Chaoyang District,Beijing were recruited as the screening subjects from May 2019 to April 2020.Transient evoked otoacoustic emission (TEOAE) and automated auditory brainstem response (AABR) were applied to newborns in stable condition 48 hours after delivery for preliminary screening.Those who failed initial screening would undergo definitive hearing assessment at the third postnatal month.Clinical information were collected through questionnaire survey in terms of gestational age,delivery mode,neonatal birth weight,hyperbilirubinemia,craniofacial malformation,history of asphyxia,history of meconium aspiration,and etc.Factors associated with the results of neonatal hearing screening were analyzed.Neonates diagnosed with hearing impairment were followed up till 6 month age.Results Out of 1 300 cases,there were1 228 cases passed hearing screening test,and the passing rate was 94.46%.The rates of failing TEOAE,AABR or combined TEOAE/AABR screening was 2.69%,4.48%and 6.24%,respectively.The failing rate of combined screening was higher than that of TEOAE screening (χ²=4.350,P=0.037).72 infants accepted hearing diagnosis test and 38 were diagnosed as hearing impairment,accounting 2.92%.Univariate analysis indicated that multiple births,birth weight,Apgar score,length of stay in NICU,hyperbilirubinemia and neonatal respiratory distress syndrome were associated with failed hearing screening (P<0.05).Further logistic regression showed that hyperbilirubinemia,multiple births,Apgar score < 10 and NICU hospital stay > 5 days were main risk factors of hearing loss (P<0.05).Conclusion NICU newborn is a high risk group of hearing impairment.TEOAE combined with AABR is an effective supplement to single way hearing screening.Therefore,it is necessary for NICU newborns to undergo early screening and regular audiological assessment.