Related Experiment Video
Updated: Jun 2, 2026
International Expert Consensus and Recommendations for Neonatal Pneumothorax Ultrasound Diagnosis and Ultrasound-guided Thoracentesis Procedure
Published on: March 12, 2020
Universal neonatal audiological screening: experience of the University Hospital of Pisa
Paolo Ghirri1, Annalisa Liumbruno, Sara Lunardi
1Mother and Child Department, Neonatology Unit and Section of Neonatal Endocrinology and Dysmorphology, University Hospital of Pisa, Pisa, Italy. pghirri@med.unipi.it
Insights
Early hearing screening for babies is crucial. Universal neonatal audiological screening programs using Transient Evoked Otoacoustic Emissions (TEOAE) and Automatic Auditory Brainstem Response (AABR) effectively identify hearing impairment in newborns.
Area of Science:
- Neonatal screening
- Audiology
- Public health
Background:
- Early identification of pre-lingual deafness is vital for minimizing long-term communication deficits.
- International guidelines recommend deafness diagnosis by three months and hearing aid treatment by six months, with cochlear implants between 12-18 months.
- Progressive or late-onset hearing loss affects 20-30% of infants, necessitating audiological follow-up programs, especially for high-risk infants.
Purpose of the Study:
- To evaluate the effectiveness of a universal newborn hearing screening program implemented at the University hospital of Pisa.
- To assess the incidence of hearing impairment and the rate of false-positives in the screened population.
Main Methods:
- Implementation of universal newborn hearing screening using Transient Evoked Otoacoustic Emissions (TEOAE) and Automatic Auditory Brainstem Response (AABR).
- Screening followed Tuscany guidelines based on the 2007 JCIH Position Statement, adapted for regional needs.
- Data collected from November 2005 to April 2009, including 8113 neonates.
Main Results:
- Out of 8113 neonates, 93.9% underwent TEOAE, and 6.1% with risk factors underwent both TEOAE and AABR.
- 84 patients (1.04%) failed both tests, with 44 (0.54%) identified as false positives.
- 34 neonates (4.2 ‰) were diagnosed with hearing impairment, including 8 (0.99 ‰) with unilateral and 26 (3.2 ‰) with bilateral hearing loss.
Conclusions:
- The screening program demonstrated a low false-positive rate (0.54%) and identified a significant incidence of bilateral hearing loss (3.2 ‰).
- Premature birth and neonatal distress were identified as primary causes of hearing loss in the studied population.
- The study supports the necessity of universal neonatal hearing screening and audiological follow-up for early intervention.
Abstract:
The early identification of pre-lingual deafness is necessary to minimize the consequences of hearing impairment on the future communication skills of a baby. According to the most recent international guidelines the deafness diagnosis must occur before the age of three months and the prosthetic-rehabilitative treatment with a traditional hearing aid should start within the first six months. When a Cochlear implant becomes necessary, the treatment should start between the age of 12 months and 18 months. The only way to diagnose the problem early is the implementation of universal neonatal audiological screening programs. Transient evoked otoacoustic emissions (TEOAE) is the most adequate test because it's accurate, economic and of simple execution. Automatic auditory brainstem response (AABR) is necessary to identify patients with auditory neuropathy but it is also important to reduce the number of false-positives.The 20-30% of infant hearing impairment is represented by progressive or late-onset hearing loss (HL) so it's also necessary to establish an audiological follow up program, especially in infants at risk.From November 2005 all neonates born in the University hospital of Pisa undergo newborn hearing screening. From 2008 the screening program follows the guidelines for the execution of the audiological screening in Tuscany which have been formulated by our group according to the 2007 JCIH Position Statement and adaptated to our regional reality by a multidisciplinary effort. From November 2005 to April 2009 8113 neonates born in the Neonatal Unit of Santa Chiara Hospital (Pisa) have undergone newborn hearing screening. 7621 neonates (93.9%) without risk factors executed only the TEOAE test. 492 (6.1%) neonates had audiological risk factors and thus underwent TEOAE and AABR. 84 patients (1,04%) failed both TEOAE and AABR tests. 78 of them underwent further investigations. 44 patients resulted false positives (the 0,54% of the screened newborns). 34 neonates (4,2 ‰) had a final diagnosis of hearing impairment. 8 patients (0.99 ‰) had unilateral hearing loss (HL). 26 patients (3,2 ‰) had bilateral hearing impairment.In our screening program the percentage of false-positives was quite low (0.54%) while the incidence of bilateral HL (3.2 ‰) is a little higher than that found in literature reports. In most of our patients premature birth or neonatal suffering represent the main cause of HL.
