Neonatal Hearing Screening Program by Otoacoustic Emission at Buriram Hospital

Abstract

Background: Hearing loss is the one of the most important cause of speech problem, impair development of language and learning disability which impact social and family. Early identification and intervention before age of 6 months can improve the child’s speech and language development. Many researches have reported a feasibility of otoacoustic emissions (OAEs) as a screener mode in newborn hearing screening.
Objectives: To determine the incidence and significant risk factors of abnormal hearing test of neonate in NICU ( Neonatal Intensive Care Unit) at Buriram hospital.
Study design: Prospective, descriptive analytic study
Subject: The 1980 newborns in NICU, born between January 1st 2008 to May 31st 2011 at Buriram hospital. There were 1529 newborns who has risk factor for abnormal hearing (high risk group) and 451 newborns who has no risk factor for abnormal hearing (low risk group ). Method: Newborns in NICU were screened with OAE device. The neonates who failed three consecutive OAE tests were refer to Rajavithi hospital for reconfirm pathological result. Chi-square test was used to identify significant risk factors with a significant level of p<0.05.
Results: The one thousand nine hundred and eighty newborns were screened with OAE device. The percentage of newborns refer to Rajavithi hospital for confirm diagnosis was about 7.06% for high risk group, 4.88% for low risk group. The incidence of combined pathologic hearing screening test was 6.57% (130 newborns) with bilateral and unilateral pathologic results in 92 newborns (4.65%) and 38 newborns (1.92%). There were 22 newborns (16.92%) with hearing loss had no risk factors. Our study found significant statistical relationships between hearing loss and craniofacial anomalies, very low birth weight less than 1500 grams, low apgar scores of zero to four at one minute or zero to six at five minutes, prolong used mechanical ventilator for at least five days and stigmata or syndrome associated with congenital hearing loss. Median age at screening test perform was 25 days ( range 5-101 days ) in high risk group and 20 days (range 2-72 days) in low risk group. Almost all newborns (99.15 % in high risk group and 100% in low risk group) were screened within 3 months of postnatal age and the follow up rate was 96.59%.
Conclusion: Our finding suggest that hearing screening by OAE device in newborns inside NICU revealed 6.57% of abnormal hearing screening (7.06% in high risk group and 4.88% in low risk group). The result of this study confirm the important of the risk factor identification as the causes of hearing loss in NICU’s newborns, to inform the parent and health care team for early intervention. Sending the high risk newborns with positive screening of hearing loss for further diagnosis and rehabilitation at the early stage can minimize the burden of hearing loss