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Outcome of Universal Neonatal Hearing Screening Programme at a Tertiary Care Centre: A Prospective Study
Kiran Upadhyay1, Vikas Gupta1, Satwinderpal Singh1
1Dept of ENT-HNS, Command Hospital, Lucknow, Uttar Pradesh India.
Insights
Universal newborn hearing screening is crucial for early detection of hearing loss in infants. This study highlights the high incidence of hearing impairment in at-risk newborns, advocating for targeted screening programs in India.
Area of Science:
- Audiology
- Neonatal Care
- Public Health
Background:
- Hearing is vital for speech, language, and overall development in neonates.
- Universal neonatal hearing screening programs are standard in developed nations but nascent in India.
- Congenital hearing impairment affects approximately 5-6 per 1000 neonates in India.
Purpose of the Study:
- To implement and assess a universal neonatal hearing screening program over three years.
- To identify the significance of risk factors associated with neonatal hearing loss.
- To ensure timely intervention for detected permanent hearing impairments.
Main Methods:
- A prospective cohort study involving 2676 neonates at a tertiary care center (Jan 2017-Dec 2019).
- A two-stage screening protocol utilizing distortion product otoacoustic emission (DPOAE) and auditory brainstem response (ABR).
- Neonates were categorized into 'at-risk' and 'no-risk' groups to analyze risk factor significance.
Main Results:
- The overall incidence of hearing impairment was 7 per 1000 live births.
- Referral rate for DPOAE was 1.53% with a 94.12% follow-up rate.
- The 'at-risk' group showed a significantly higher incidence of hearing impairment (41.38 per 1000) compared to the 'no-risk' group (2.9 per 1000) (p < 0.05).
Conclusions:
- Hospital-based universal newborn hearing screening before discharge is feasible in tertiary care settings.
- The high incidence (0.7%) of congenital hearing impairment supports the need for universal screening.
- Given resource limitations in India, prioritizing screening for high-risk neonates is recommended.
Abstract:
Hearing is an important sense organ for human beings essential for speech, language and overall development. Universal neonatal hearing screening programmes are mandatory in many developed countries. In India out of 1000 neonates approximately 5-6 infants are diagnosed with hearing impairment but still universal neonatal hearing screening programme is in its infancy. To screen all neonates delivered at our centre in three years, with secondary objective of determining the significance of risk factors with neonatal hearing loss and to provide appropriate intervention following the detection of a permanent hearing impairment. It is a non-randomised prospective cohort study conducted at a tertiary care centre to screen all neonates born between Jan 2017 and Dec 2019 with 2 stage protocol using distortion product otoacoustic emission and auditory brainstem response. The study population was also divided into two groups, ''at risk'' and ''no risk'' groups to determine the significance of risk factors on neonatal hearing loss. Total 2676 neonates were screened, OAE referral rate was 1.53%. There was a 94.12% follow up. The incidence of hearing impairment was found to be 7 per 1000(In the "no risk" group, 2.9 per 1000 and in the "at risk" group, 41.38 per 1000). Statistically, a significant difference was found in the incidence of hearing impairment between the two groups (p < 0.05, chi-square Test). Hospital based universal hearing screening of new born before discharge is feasible at a tertiary care centre. A high incidence of 0.7% congenital hearing impairment warrants universal newborn hearing screening programme. Considering the limitations and infrastructure in India, we should at least employ screening for all high risk neonates.
