Risk factors for hearing loss in infants under universal hearing screening program in Northern Thailand
Watcharapol Poonual1, Niramon Navacharoen2, Jaran Kangsanarak2
1Clinical Epidemiology Program, Chiang Mai University, Chiang Mai, Thailand.
Insights
Infant hearing loss risk factors include low birth weight, poor APGAR scores, craniofacial anomalies, sepsis, and ototoxic exposure. Universal hearing screening is crucial for early detection and prevention of disability.
Area of Science:
- Pediatrics
- Public Health
- Audiology
Background:
- Infant hearing loss is a significant concern, impacting development and quality of life.
- Early identification through universal hearing screening programs is vital for timely intervention.
Purpose of the Study:
- To identify specific risk factors associated with hearing loss in 3-month-old infants.
- To inform the implementation and effectiveness of universal hearing screening programs.
Main Methods:
- Prospective cohort study involving 3,120 infants aged 3 months undergoing automated otoacoustic emission testing.
- Risk factors were analyzed using univariable and multivariable statistical models.
Main Results:
- A 4.3% prevalence of hearing loss was detected.
- Key risk factors identified: birth weight 1,500-2,500g, APGAR score <6 at 5 minutes, craniofacial anomalies, sepsis, and ototoxic exposure.
Conclusions:
- Low birth weight, low APGAR scores, craniofacial anomalies, sepsis, and ototoxic exposure are significant risk factors for infant hearing loss.
- Universal hearing screening before 36 weeks is recommended for all infants.
- Public health policies supporting universal screening are essential for disability prevention and improving quality of life.
Objective:
To define the risk factors for hearing loss in infants (aged 3 months) under universal hearing screening program.
Materials And Methods:
A total of 3,120 infants (aged 3 months) who underwent hearing screening using a universal hearing screening program using automated otoacoustic emission test between November 1, 2010 and May 31, 2012 in Uttaradit Hospital, Buddhachinaraj Hospital, and Sawanpracharuk Hospital (tertiary hospitals) located in Northern Thailand were included in this prospective cohort study.
Results:
Of the 3,120 infants, 135 (4.3%) were confirmed to have hearing loss with the conventional otoacoustic emission test. Five of these 135 infants (3.7%) with hearing loss showed test results consistent with auditory brainstem responses. From the univariable analysis, there were eleven potential risk factors associated with hearing deterioration. On multivariable analysis, the risk factors independently associated with hearing loss at 3 months were birth weight 1,500-2,500 g (risk ratio [RR] 1.6, 95% confidence interval [CI] 1.1-2.6), APGAR score <6 at 5 minutes (RR 2.2, 95% CI 1.1-4.4), craniofacial anomalies (RR 2.5, 95% CI 1.6-4.2), sepsis (RR 1.8, 95% CI 1.0-3.2), and ototoxic exposure (RR 4.1, 95% CI 1.9-8.6).
Conclusion:
This study concluded that low birth weight, APGAR score <6 at 5 minutes, craniofacial anomalies, sepsis, and ototoxic exposure are the risk factors for bilateral hearing loss in infants (aged 3 months) and proper tests should be performed to identify these risk factors. As an outcome, under the present circumstances, it is suggested that infirmary/physicians/general practitioners/health action centers/polyclinics should carry out universal hearing screening in all infants before 36 weeks. The public health policy of Thailand regarding a universal hearing screening program is important for the prevention of disability and to enhance people's quality of life.
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