Newborn hearing screening at a community-based obstetric unit: Screening and diagnostic outcomes

Area of Science:

• Audiology
• Public Health
• Neonatal Care

Background:

• Community-based midwife obstetric units (MOUs) are proposed for primary healthcare screening in South Africa.
• Evaluating newborn hearing screening at these community sites is crucial for early detection and intervention.

Purpose of the Study:

• To assess the effectiveness of distortion product otoacoustic emissions (DPOAE) and automated auditory brainstem response (AABR) screening for hearing loss in newborns.
• To determine the feasibility of non-professional screeners conducting universal newborn hearing screening (UNHS) at community-based MOUs.

Main Methods:

• A 16-month comparative study evaluated DPOAE and AABR screening technologies.
• Non-professional screeners conducted two-stage screening protocols for bilateral hearing loss.
• Infants with failed initial screens underwent rescreening and diagnostic follow-up.

Main Results:

• 7452 infants were screened; AABR showed a lower initial referral rate (4.6%) than DPOAE (7.0%).
• Follow-up rates were high for both technologies (DPOAE: 90-92.3%, AABR: 86.6-90%).
• A higher prevalence of bilateral sensorineural hearing loss (SNHL) was detected with AABR (1/1000) compared to DPOAE (0.3/1000).

Conclusions:

• Community-based MOUs provide an effective platform for newborn hearing screening and follow-up.
• AABR screening is a cost-effective and efficient option for community-based programs.
• AABR demonstrates advantages over DPOAE with lower initial referrals and higher true positive rates.