Universal Screening of Newborns from a Tertiary Care Hospital in South India: A Prospective Analytical Study

TL;DR

This study found a 0.29% prevalence of hearing impairment in newborns in South India and identified several risk factors, emphasizing the need for universal newborn hearing screening.

Contribution

The study provides updated prevalence data and identifies significant risk factors for hearing impairment in a South Indian population.

Findings

The prevalence of hearing impairment in newborns was 0.29%.

TORCH infections, low birth weight, and low APGAR scores were significantly associated with hearing impairment.

Universal newborn hearing screening is recommended for early diagnosis and intervention.

Abstract

To estimate the prevalence of hearing impairment and significant risk factors for congenital loss in a tertiary hospital in South India.

Over 3 years, a prospective analytical study was conducted in the Department of Otorhinolaryngology in a tertiary hospital in South India. All newborns born in the hospital or those referred were initially screened using the Transient Evoked Otoacoustic Emissions (TEOAE) in a soundproof room by a trained audiologist at 24 to 48 hours of birth. Results were either “PASS” or “REFER.” Those who did not pass the initial screening were retested with TEOAE at their 6-week vaccination appointment. If the second result was “REFER,” the neonate underwent Brain Evoked Response Auditory (BERA) for confirmation.

A total of 3,679 neonates (1,931 males, 1,748 females) underwent TEOAE testing. Of those, 2,426 (65.9%) passed the first test, and 1,253 (34.1%) were referred. The second TEOAE test was done for 1,174 patients, with results of 1,013 (86.29%) as “PASS” and 161 (13.71%) as “REFER.” The BERA results of 95 neonates showed normal in 84 (88.42%), and 11 (11.58%) had profound hearing loss. The prevalence of hearing impairment in the present study was 0.29% (95% CI: 0.2–0.6%). Major risk factors such as maternal infections, like toxoplasmosis, others (syphilis, hepatitis B), rubella, cytomegalovirus, and herpes simplex (TORCH), craniofacial anomalies, low birth weight < 1,500 g, low Appearance, Pulse, Grimace, Activity and Respiration (APGAR) scores (0–4 at 1 minute and 0–6 at 5 minutes), and mechanical ventilation lasting for 5 days or longer, were significantly associated with hearing impairment at
p
 < 0.05.

Newborn hearing screenings must be made mandatory, irrespective of risk factors. This way, early diagnosis and necessary interventions can be implemented.

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