Hearing Impairment among the High-Risk Neonates: Findings from a Hospital-Based Targeted Screening.

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.