Pediatric ABR screening: pass-fail rates in awake versus asleep neonates

The auditory brainstem response (ABR) is commonly used as a neonatal hearing screening tool. The degree to which myogenic and/or movement artifact can confound the ABR in neonates, and the effect this has on screening pass-fail rates, although widely recognized, have not been reported. This study addressed these aspects in a clinical setting. Fifty-two high-risk neonates were screened in various states of activity (asleep, awake-calm, awake-active). Pass-fail rates between asleep and awake babies were significantly different (p less than 0.5), with the awake group displaying a much higher failure rate. There was no significant difference between the awake-calm and awake-active groups. Results indicate that activity state should be noted and considered along with the other factors that are generally blamed for false-positive results in neonatal ABR screenings.