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Incidence and Risk Factors of Hearing Impairment in Full-Term Neonatal Intensive Care Unit (NICU) Graduates: A
Yogesh Pehlajani1, Jyotsna Shrivastava2, Shipra Mandraha2
1Pediatrics, Netaji Subhash Chandra Bose Medical College, Jabalpur, IND.
Insights
Full-term neonates from the neonatal intensive care unit (NICU) have a 13 per 1,000 incidence of hearing impairment. Key risk factors include meningitis, hypoxic-ischemic encephalopathy, and ototoxic medication use, necessitating early auditory screening.
Area of Science:
- Neonatal care
- Audiology
- Public health
Background:
- Early hearing screening is crucial for neonatal intensive care unit (NICU) graduates to ensure optimal development.
- Full-term NICU graduates are a vulnerable population often overlooked for hearing impairment risks.
- Identifying maternal and neonatal risk factors for hearing loss is essential for timely intervention.
Purpose of the Study:
- To determine the incidence of hearing impairment in full-term neonates discharged from the NICU.
- To assess the association between maternal/neonatal risk factors and hearing loss in this population.
Main Methods:
- Prospective, observational, cross-sectional study of 229 full-term NICU graduates.
- Hearing screening using distortion product otoacoustic emissions (DPOAE) and brainstem evoked response audiometry (BERA).
- Statistical analysis including descriptive statistics and chi-square/Fisher's exact test.
Main Results:
- An incidence of 13 per 1,000 NICU graduates with confirmed hearing impairment was found.
- Significant risk factors identified: meningitis, hypoxic-ischemic encephalopathy (HIE), bilirubin encephalopathy, oligohydroaminos, and prolonged ototoxic medication use (>5 days).
Conclusions:
- Full-term NICU graduates are at significant risk for hearing impairment.
- Routine and comprehensive auditory screening is necessary for early detection.
- Timely intervention based on early detection can reduce long-term disability.
Background:
Early hearing screening of full‑term neonates discharged from the neonatal intensive care unit (NICU) is essential to enable timely interventions that support optimal language and cognitive development. Despite their potential vulnerability, this population has received limited attention compared with preterm infants, underscoring the need to establish the incidence of hearing impairment and identify key maternal and neonatal risk factors. The primary objective of this study was to determine the incidence of hearing impairment among full-term neonates discharged from the NICU. The secondary objective was to assess the association of various maternal and neonatal risk factors with the occurrence of hearing loss.
Methods:
This prospective, observational, cross-sectional study was conducted at the Department of Pediatrics, Gandhi Medical College, Bhopal, India, from September 2022 to March 2024. A total of 229 full-term NICU graduates were enrolled using predefined inclusion criteria. Hearing screening was conducted using distortion product otoacoustic emissions (DPOAE) as the initial and repeat test, followed by brainstem evoked response audiometry (BERA) for neonates who failed the second DPOAE. Data were analyzed using IBM SPSS Statistics software, version 25 (IBM Corp., Armonk, NY), employing descriptive statistics and the chi-square/Fisher's exact test for associations.
Results:
Of the 229 neonates screened, three were found to have confirmed hearing impairment based on BERA, yielding an incidence of 13 per 1,000 NICU graduates. Significant associations were noted between hearing impairment and risk factors such as meningitis (p=0.0262), hypoxic-ischemic encephalopathy (HIE) (p=0.0044), bilirubin encephalopathy (p=0.022), oligohydroaminos (p=0.0001), and ototoxic medication use (>5 days) (p=0.049).
Conclusion:
In conclusion, the study highlights that full-term NICU graduates are at risk for hearing impairment and require the need for routine and comprehensive auditory screening. Early detection enables timely intervention, thereby reducing long-term disability.
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