Abstract
Objective The aim of this study is to estimate the incidence of hearing loss in neonates at a tertiary referral center, to assess the associated risk factors in those identified with hearing loss and to explore the challenges of starting and continuing a universal neonatal hearing screening programme in a tertiary care hospital over a decade. Materials and Methods It is a cohort prospective observational study conducted from January 2008 to January 2018. Five thousand five hundred and forty neonates underwent screening for hearing loss, of which 2688 were well babies and 2854 babies had one or more risk factors causing hearing loss. Otoacoustic emissions (OAE) is employed as the first level of screening within one month of birth. Brainstem evoked response audiometry (BERA) is done at 3 months of gestational age for all the well babies who were referred on OAE testing and all the high risk babies irrespective of the result of the OAE screening. The High risk criteria are based on the set criteria by the Joint Committee on Infant Hearing (2007) and American Academy of Pediatrics (1994). Results In our study the incidence of hearing impairment is 5.41 per 1000 neonates screened. In well babies and at risk babies it is 1.49 and 9.11 per 1000 respectively.The common neonatal risk factors associated with hearing loss in our study are babies admitted to neonatal intensive care units (NICU), intrauterine growth retardation (IUGR), birth weight less than 1500 g, respiratory distress syndrome (RDS) and hyperbilirubinemia. Conclusion The incidence of hearing loss in our study is comparable to that reported in literature (Bachmann KR, ArvedsonJC (1998) Early identification and intervention for children who are hearing impaired. Pediatr Rev. 1998 May; Vol. 19. No.5. pp. 155–165. http://www.ncbi.nlm.nih.gov/pubmed/9584525 Accessed from May 1998, Nagapoornima P, Ramesh A, Srilakshmi, Rao S, Patricia PL, Gore M, et al. Universal hearing screening. Indian J Pediatr. 2007 Jun 18; 74(6):545–9., Augustine AM, Jana AK, Kuruvilla KA, Danda S, Lepcha A, Ebenezer J, et al. (2014) Neonatal hearing screening-experience from a tertiary care hospital in southern India. Indian Pediatr. Vol. 51. No.3. pp 179–183. http://www.ncbi.nlm.nih.gov/pubmed/24277966 Accessed from Mar 2014). Hearing loss is more common in those babies with risk factors as reported in literature (Nagapoornima P, Ramesh A, Srilakshmi, Rao S, Patricia PL, Gore M, et al. Universal hearing screening. Indian J Pediatr. 2007 Jun 18; 74(6):545–9. http://www.ncbi.nlm.nih.gov/pubmed/21654001 Paul AK (2011) Early identification of hearing loss and centralized newborn hearing screening facility-the Cochin experience. Indian Pediatr. Vol. 48. No. 5. pp 355–359. Accessed from May 2011). Implementation of neonatal hearing screening program at a tertiary care hospital using a two tier system with OAE and BERA is a feasible but challenging service.
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Bachmann KR, ArvedsonJC (1998) Early identification and intervention for children who are hearing impaired. Pediatr Rev. 1998 May; Vol. 19. No.5. pp. 155–165. http://www.ncbi.nlm.nih.gov/pubmed/9584525. Accessed from May 1998
Nagapoornima P, Ramesh A, Srilakshmi RS, Patricia PL, Gore M et al (2007) Universal hearing screening. Indian J Pediatr 74(6):545–549
Augustine AM, Jana AK, Kuruvilla KA, Danda S, Lepcha A, Ebenezer J, et al. (2014) Neonatal hearing screening-experience from a tertiary care hospital in southern India. Indian Pediatr. Vol. 51. No.3. pp 179–183. http://www.ncbi.nlm.nih.gov/pubmed/24277966. Accessed from Mar 2014
Paul AK (2011) Early identification of hearing loss and centralized newborn hearing screening facility-the Cochin experience. Indian Pediatr. Vol. 48. No. 5. pp 355–359. http://www.ncbi.nlm.nih.gov/pubmed/21654001. Accessed from May 2011
Kennedy CR, McCann DC, Campbell MJ, Law CM, Mullee M, Petrou S, et al. (2006) Language ability after early detection of permanent childhood hearing impairment. N Engl J Med. 2006 May 18; 354(20):2131–2141. Available from: http://www.ncbi.nlm.nih.gov/pubmed/16707750
World Health Organisation. (2020) Deafness and hearing loss [Internet].[Updated 2020 March 1; cited 2020 May 23]. https://www.who.int/news-room/fact-sheets/detail/deafness-and-hearing-loss. Accessed from 23 May 2020
Kral A, Tillein J, Heid S, Hartmann R, Klinke R (2005) Postnatal cortical development in congenital auditory deprivation. Cereb Cortex 15(5):552–562
American Academy of Pediatrics, Joint Committee on Infant Hearing JC on I (2007) position statement: principles and guidelines for early hearing detection and intervention programs. Pediatrics. Vol. 120. No. 4. pp 898–921. http://www.ncbi.nlm.nih.gov/pubmed/17908777. Accessed from 1 Oct 2007
Joint Committee on Infant Hearing (2019) Position statement: principles and guidelines for early hearing detection and intervention programs. J Early Hearing Detec Intervention. Vol. 4. No. 2. pp 1–44. DOI: https://doi.org/10.15142/fptk-b748. https://digitalcommons.usu.edu/jehdi/vol4/iss2/1. Accessed from 2019
Wake M, Ching TY, Wirth K et al (2016) Population outcomes of three approaches to detection of congenital hearing loss. Pediatrics 137(1):e20151722. https://doi.org/10.1542/peds.2015-1722 ([Internet])
Dyk V, Swanepoel M, Iii D, James S (2015) Outcomes with OAE and AABR screening in the first 48h—Implications for newborn hearing screening in developing countries. Int J Ped Otorhinolaryngol. https://doi.org/10.1016/j.ijporl.2015.04.021
Ruben RJ (1991) Effectiveness and efficacy of early detection of hearing impairment in children. Acta Otolaryngol Suppl. Vol. 482. pp 127–131; discussion 132–5. http://www.ncbi.nlm.nih.gov/pubmed/1897357. Accessed from 1991
Rai N, Thakur N (2013) Universal screening of newborns to detect hearing impairment—Is it necessary? Int J Pediatr Otorhinolaryngol. Vol. 77. No. 6. pp 1036–1041 http://www.ncbi.nlm.nih.gov/pubmed/23642585
Jewel J, Varghese PV, Singh T, Varghese A (2013) Newborn hearing screening — experience at a tertiary hospital in northwest India. Int J Otolaryngol Head Neck Surg 2013(September):211–214
Gupta S, Sah S, Som T, Saksena M, Yadav CP, Sankar MJ, et al. (2015) Challenges of implementing universal newborn hearing screening at a tertiary care centre from India. Indian J Pediatr. Vol. 82. No. 8. pp 688–693. http://www.ncbi.nlm.nih.gov/pubmed/25652547. Accessed from 6 Aug 2015
John M, Balraj A, Kurien M (2009) Neonatal screening for hearing loss: pilot study from a tertiary care center. Indian J Otolaryngol Head Neck Surg 61(1):23–26. https://doi.org/10.1007/s12070-009-0028-2
James M, Kumar P, Ninan PJ, James M (2018) Pediatr JC (2018) A study on prevalence and risk factors of hearing impairment among newborns. Int J Contemp Pediatr 5(2):304–309
Sachdeva K, Sao T (2017) Outcomes of newborn hearing screening program: a hospital based study. Indian J Otolaryngol Head Neck Surg. 69(2):194–198
Paul AK (2016) Centralized newborn hearing screening in Ernakulam, Kerala. Experience Over a Decade. Indian Pediatr 53(1):15–17
Meyer C, Witte J, Hildmann A, Hennecke K, Maul K, Franke U et al (1999) Neonatal screening for hearing disorders in infants at risk. Pediatrics. https://doi.org/10.1542/peds.104.4.900
Appelbaum EN, Howell JB, Chapman D, Pandya A, Dodson KM (2018) Analysis of risk factors associated with unilateral hearing loss in children who initially passed newborn hearing screening. Int J Pediatr Otorhinolaryngol. https://doi.org/10.1016/j.ijporl.2018.01.024
Korres S, Nikolopoulos TP, Komkotou V, Balatsouras D, Kandiloros D, Constantinou D et al (2005) Newborn hearing screening: effectiveness, importance of high-risk factors, and characteristics of infants in the neonatal intensive care unit and well-baby nursery. Otol Neurotol. https://doi.org/10.1097/01.mao.0000184602.94677.41
Bielecki I, Horbulewicz A, Wolan T (2011) Risk factors associated with hearing loss in infants: an analysis of 5282 referred neonates. Int J Pediatr Otorhinolaryngol. https://doi.org/10.1016/j.ijporl.2011.04.007
Finitzo T, Albright K, O’Neal J (1998) The newborn with hearing loss: detection in the nursery. Pediatrics. Vol. 102. No 6. pp 1452–1460. http://www.ncbi.nlm.nih.gov/pubmed/9832584. Accessed from Dec 1998
Vaid N, Shanbhag J, Nikam R, Biswas A, Ears B (2009) Neonatal hearing screening- the Indian experience. Cochlear Implants Int. Vol. 10. No. Suppl 1. pp 111–114. http://www.tandfonline.com/doi/full/https://doi.org/10.1179/cim.2009.10.Supplement-1.111 DOI: https://doi.org/10.1179/cim.2009.10.Supplement-1.111. Accessed from 13 Jan 2009
Li P-C, Chen W-I, Huang C-M, Liu C-J, Chang H, Lin H-C (2016) Comparison of newborn hearing screening in well-baby nursery and NICU: a study applied to reduce referral rate in NICU. PLoS ONE 11(3):0152028
Shulman S, Besculides M, Saltzman A (2010) Pediatrics HI 2010 undefined. Evaluation of the universal newborn hearing screening and intervention program. Am Acad Pediatr. 126(Supplement1):S19-27
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Kapadia, M., Vaid, N. & Vaze, V. UNHS: A Decade Long Feasibility and Sustenance Study from a Tertiary Care Hospital in India. Indian J Otolaryngol Head Neck Surg 74 (Suppl 1), 624–630 (2022). https://doi.org/10.1007/s12070-021-02435-w
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DOI: https://doi.org/10.1007/s12070-021-02435-w