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Hearing Impairment among the High-Risk Neonates: Findings from a Hospital-Based Targeted Screening
A L Halder1, M A H Mollah, M A Baki
1Dr Amrita Lal Halder, Associate Professor, Department of Neonatology and Paediatrics, BIRDEM General Hospital, Dhaka, Bangladesh;
Insights
This study found 9.5% of high-risk infants have hearing impairment. Key risk factors include ototoxic drug use and low birth weight, highlighting the need for early infant hearing screening.
Area of Science:
- Neonatal care
- Audiology
- Public Health
Background:
- Early life hearing impairment negatively impacts speech, language, and communication development.
- Infant hearing impairment is an invisible disability, making early screening crucial for identification.
- This study addresses the need to understand hearing impairment prevalence and risk factors in hospitalized, high-risk neonates.
Purpose of the Study:
- To estimate the prevalence of hearing impairment in high-risk neonates.
- To identify significant risk factors associated with hearing impairment in this population.
- To inform early intervention strategies for affected infants.
Main Methods:
- A cross-sectional study involving 282 high-risk neonates admitted to a Special Care Baby Unit (SCABU).
- Screening using distortion product otoacoustic emissions (DPOAE) at two time points.
- Confirmation of hearing impairment via auditory brainstem response audiometry (ABR) at three months of age.
Main Results:
- A prevalence of 9.5% for hearing impairment was observed, with 7.4% unilateral and 2.1% bilateral.
- The most common risk factors identified were prolonged use of ototoxic drugs (37.9%) and low birth weight (<1500gm, 10.6%).
- Independent risk factors included family history of hearing loss, craniofacial anomalies, hyperbilirubinemia requiring exchange transfusion, and prolonged mechanical ventilation.
Conclusions:
- The prevalence of hearing impairment in this high-risk neonatal cohort is significant at 9.5%.
- Specific clinical factors such as family history, craniofacial anomalies, severe hyperbilirubinemia, and extended mechanical ventilation are independently associated with hearing impairment.
- Early and targeted hearing screening in high-risk neonates is essential for timely diagnosis and intervention to mitigate developmental consequences.
Abstract:
Hearing impairment in early life can have deleterious effects on speech and language development and so as in communication. As hearing impairment in the infant is an invisible disability, screening is one of the most important methods of early identification. In this study, we screened the hospitalized high-risk neonates to estimate the prevalence of hearing impairment and to identify the risk factors in our settings. This cross-sectional study was conducted on 282 high-risk neonates admitted to the Special Care Baby Unit (SCABU), BIRDEM (Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders) General Hospital-2, Dhaka, Bangladesh, from January 2019 to December 2019. The screening was done by distortion product otoacoustic emissions (DPOAE); first, by the age of 30 days, and second, two weeks after the first screening. Hearing impairment was confirmed by auditory brain stem response audiometry (ABR), which was performed at the age of three months. The prevalence of hearing impairment was found to be 9.5%. Among them, 7.4% had unilateral (right or left ear) and 2.1% had a bilateral hearing impairment. There was no gender predominance (p=0.92). The most prevalent risk factors were the use of ototoxic drugs (amikacin/ gentamycin ± furosemide) for more than 5 days or multiple courses (n=107, 37.9%) and birth weight less than 1500gm (n=30, 10.6%). The family history of hearing loss (OR=10.924, CI: 1.609-74.150, p= 0.014), craniofacial anomalies involving pinna and ear canal (OR=12.214, CI: 1.294-85.268, p=0.029), Hyperbilirubinemia at a serum level requiring exchange transfusion (OR=8.689, CI: 2.044-36.931, p=0.003) and needing mechanical ventilation for more than 5 days (OR=4.695, CI: 1.075-20.506, p=0.040) were detected as independent risk factors for hearing impairment in these high-risk neonates. The prevalence of hearing impairment among the high-risk neonates was 9.5%. The family history of hearing loss, craniofacial anomalies involving the pinna and ear canal, hyperbilirubinemia at the exchange level, and needing mechanical ventilation for more than 5 days was independent risk factors for hearing impairment in high-risk neonates.
