Related Experiment Video
Updated: May 9, 2026
Behavioral Assessment of Hearing in 2 to 4 Year-old Children: A Two-interval, Observer-based Procedure Using Conditioned Play-based Responses
Published on: January 23, 2017
Impact of gestational age on neonatal hearing screening in vaginally-born late-preterm and early-term infants
Tatiana Smolkin1, Yasmin Anton, Irena Ulanovsky
1Department of Neonatology, Meyer Children's Hospital, Rambam Medical Center, Haifa, Israel.
Insights
Late-preterm and early-term infants are twice as likely to fail their initial hearing screening (otoacoustic emissions test). Performing the test after 42 hours of life significantly reduces failure rates in these infants.
Area of Science:
- Neonatal care
- Audiology
- Pediatric screening
Background:
- Late-preterm and early-term (LP-ET) infants (35-37 weeks' gestation) frequently fail their initial otoacoustic emissions (OAE) hearing test.
- LP-ET infants exhibit higher failure rates on the first OAE test compared to full-term infants (38-42 weeks' gestation).
Purpose of the Study:
- To investigate the impact of gestational age on the outcomes of the first otoacoustic emissions (OAE) test.
- To determine optimal timing for OAE testing in late-preterm and early-term infants.
Main Methods:
- A cohort of 1,572 vaginally-delivered infants born at or after 35 weeks' gestation were studied.
- Data collected included perinatal and neonatal variables, and results of the first otoacoustic emissions (OAE) test.
- Statistical analyses, including univariate and multivariate, were used to identify factors associated with OAE test failure.
Main Results:
- Late-preterm and early-term infants required repeat hearing tests at twice the rate of full-term infants (80.2 vs. 43.3 per 1,000 neonates).
- Failure on the first OAE test was significantly associated with late prematurity (OR 2.0) and younger age at testing (OR 9.2).
- At 24-42 hours of age, LP-ET infants had a 2-fold higher failure rate (9.4% vs. 4.7% in term infants); this risk decreased significantly after 42 hours.
Conclusions:
- Vaginally-delivered late-preterm and early-term infants demonstrate a two-fold higher rate of failure on the initial OAE test, particularly when performed within 42 hours of life.
- Hearing test failure rates become minimal in both LP-ET and term infants after 42 hours of age.
- For optimal results in vaginally-delivered LP-ET infants, the first otoacoustic emissions test should be conducted after 42 hours of age.
Background:
Late-preterm and early-term (LP-ET) infants, defined herein as 35(0)-37(6) weeks' gestation, often fail on 1st otoacoustic emissions (OAE) test.
Hypothesis:
LP-ET infants fail more than term infants (38(0)-42 weeks' gestation) on the 1st OAE test. Aim : To evaluate the effect of gestational age on the 1st OAE test.
Methods:
We studied 1,572 vaginally-delivered (VD) infants ≥35 weeks' gestation (1.1.2011-30.9.2011). Perinatal and neonatal variables and results of OAE tests were recorded.
Results:
LP-ET infants, compared to full-term infants, had a significantly 2-fold higher need for repeated hearing tests: 80.2 versus 43.3 tests/1,000 neonates, respectively (p = 0.026). Univariate analysis showed that late prematurity and age at 1st OAE were significantly associated with failure on 1st OAE. At age 24-42 h, failure on 1st OAE was 2-fold higher in the LP-ET infants than in full-term infants: 9.4 versus 4.7% (p = 0.02). Risk for failure on 1st OAE was age-dependent: 9-fold higher when 1st OAE was performed at 24-42 h of age (5.3%) versus 0.6% after age 42 h. Multivariate analysis showed that variables that were independently significantly associated with failure on 1st OAE included late prematurity (OR 2.0 (1.1-3.7)) and age at 1st OAE (OR 9.2 (1.2-70.7)).
Conclusions:
Compared to term infants, VD LP-ET infants had 2-fold higher rates of failure on 1st OAE (up to 42 h of life) and needed repeated hearing tests. Failure rates after 42 h become negligible in both groups. In VD LP-ET infants, 1st OAE is better performed after 42 h of age.
