Conductive hearing loss in newborns: Hearing profile, risk factors, and occasions of service
Alison Collins1, Rachael Beswick2, Carlie Driscoll3
1Hearing Research Unit for Children, Division of Audiology, School of Health & Rehabilitation Sciences, The University of Queensland, Brisbane, 4072, Australia; Children's Health Queensland Hospital and Health Service, Child and Youth Community Health Service, 10 Chapel Street, Nundah, Queensland, 4012, Australia.
Insights
Infants with hearing loss risk factors required more services for diagnosis. Clinical factors influenced conductive hearing loss (CHL) profiles, with early identification aiding management.
Area of Science:
- Audiology
- Pediatrics
- Public Health
Background:
- Conductive hearing loss (CHL) in infants is linked to developmental delays.
- Universal Newborn Hearing Screening (UNHS) identifies infants with CHL.
- Early diagnosis and intervention are crucial for infant development.
Purpose of the Study:
- To examine the association between infant characteristics and the number of services needed for CHL diagnosis.
- To investigate how demographic and clinical factors correlate with the CHL profile (unilateral vs. bilateral, severity).
Main Methods:
- Retrospective analysis of 1208 infants with CHL identified via UNHS (2007-2018).
- Chi-squared analysis used to compare groups based on risk factors, demographics, and CHL characteristics.
Main Results:
- Infants with hearing loss risk factors needed more than three service occasions for diagnosis.
- Bilateral CHL was more common in infants with risk factors, Torres Strait Islander background, prematurity, or medical exclusion.
- Syndromic infants showed a higher proportion of bilateral CHL; craniofacial abnormalities, prolonged ventilation, or syndromes were linked to mild-to-moderate CHL.
- Average diagnosis age was 37.29 weeks; CHL severity was not associated with laterality.
Conclusions:
- Clinical and demographic factors influence the diagnostic pathway and CHL profile in infants.
- Understanding these relationships can optimize clinical assessment and management strategies for infants with CHL through UNHS.
Objective:
Infants diagnosed with a conductive hearing loss (CHL) are at increased risk of developmental delays. Using a sample of infants diagnosed with CHL through UNHS, this study aimed to investigate the relationship between specific demographic or clinical characteristics and 1) occasions of service to reach a hearing diagnosis and 2) the profile of CHL.
Methods:
Retrospective analysis was conducted for all infants with CHL born between 01/01/2007 and 31/12/2018 who had received UNHS. Chi squared analysis was conducted on data from 1208 records.
Results:
Infants with ≥1 risk factor for hearing loss were more likely to attend more than three occasions of service. Infants who were bilateral refer/medical exclusion, Torres Strait Islander, had ≥1 risk factors for hearing loss or were born pre-term had greater proportions of bilateral CHL than unilateral CHL. Mild to moderate was the most frequent degree of CHL, although a unilateral or bilateral CHL did not have an association with the severity of CHL. Compared to other risk factors, infants with a syndrome had greater proportions of bilateral than unilateral CHL. Risk factors of craniofacial abnormality, prolonged ventilation, or syndrome had greater proportions of mild to moderate CHL than moderate or greater. On average, infants were diagnosed with a CHL at 37.29 weeks of age.
Conclusion:
These findings highlight the relationship between clinical/demographic characteristics and occasions of service to diagnose CHL in children, including the CHL profile. An understanding of this relationship may help clinicians to better plan, assess and manage infants diagnosed with a CHL through UNHS.
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