Outcome of Hearing Screening using Automated Auditory Brainstem Response (AABR) in Neonates Delivered through High...

Background High-risk pregnancies increase the likelihood of neonatal hearing impairment, yet early signs are often subtle or absent, delaying diagnosis. Early identification through newborn hearing screening is critical to prevent long-term auditory and developmental deficits. Objective To evaluate neonatal hearing screening outcomes using Automated Auditory Brainstem Response (AABR) in neonates born through high-risk pregnancies at Dhulikhel Hospital. Method In this prospective study, neonates born between 15th March 2023 and 15th September 2024 through high-risk pregnancies were screened using Automated auditory brainstem response within 24 hours of birth. Neonates failing the initial screening were re-tested at six weeks. Maternal risk factors including hypothyroidism, diabetes, hypertension, pre-eclampsia, renal disorders, STDs, psychiatric disorders, heart disease, smoking, and extreme maternal age were recorded. Neonates failing the second screening were referred and tested with diagnostic automated auditory brainstem response . Result Ninety neonates (41 males, 49 females) were included. Thirty-two neonates failed the initial automated auditory brainstem response , and nine failed the second screening, yielding a referral rate of 10%. Maternal hypothyroidism was the most common risk factor among referred cases. Other maternal factors associated with referrals included diabetes, maternal age ≥ 35 years, pre-eclampsia, smoking, and STDs. The overall diagnostic automated auditory brainstem response failure rate was 3.3%, highlighting the low but significant prevalence of hearing impairment among high-risk pregnancies. Conclusion Maternal health conditions, particularly hypothyroidism, diabetes, and advanced maternal age, are associated with increased risk of neonatal hearing impairment. automated auditory brainstem response is an effective screening tool in high-risk populations, and early detection with timely intervention is essential to optimize auditory and developmental outcomes.