Prediction of permanent hearing loss in high-risk preterm infants at term age

Area of Science:

• Neonatal care
• Audiology
• Developmental pediatrics

Background:

• High-risk preterm infants require accurate hearing screening to detect permanent bilateral hearing loss.
• Early identification of hearing defects is crucial for timely intervention and management.

Purpose of the Study:

• To evaluate the effectiveness of auditory brainstem responses (ABR), transient evoked otoacoustic emissions (TEOAE), and free field (FF) auditory responses in predicting permanent bilateral hearing loss in high-risk preterm infants.
• To compare the diagnostic performance of different hearing screening methods.

Main Methods:

• 51 preterm infants (gestational age < 34 weeks, birth weight < 1500 g) underwent hearing screenings (ABR, TEOAE, FF) at term post-conceptional age.
• Follow-up assessments of hearing, speech, and neurological development were conducted until 18 months corrected age.
• Significant hearing defects were confirmed with comprehensive ABR examinations and clinical observations.

Main Results:

• Bilateral failure in ABR screening predicted hearing loss with 100% sensitivity and 98% specificity.
• TEOAE screening showed 50% sensitivity and 84% specificity.
• FF examination had 50% sensitivity and 98% specificity.
• Six preterm infants were diagnosed with permanent bilateral hearing loss, four also had cerebral palsy.

Conclusions:

• Auditory brainstem response (ABR) screening is highly effective for identifying hearing loss in high-risk preterm infants.
• Transient evoked otoacoustic emissions (TEOAE) may be less suitable due to potential retrocochlear damage.
• ABR is recommended as a more reliable screening method for this population.