COMPARATIVE STUDY OF HEARING ASSESSMENT IN NORMAL AND HIGH RISK INFANTS BY NEWBORN HEARING SCREENING

Abstract

Background: Early identification of hearing impairment in neonates is essential for timely intervention, which can profoundly affect speech, language, and cognitive development. High-risk infants are more susceptible to hearing loss due to factors like prematurity, low birth weight, and exposure to ototoxic medications. This study aims to assess hearing outcomes in normal and high-risk infants using newborn hearing screening methods, promoting early detection and intervention to enhance developmental outcomes.

Objective: To compare the incidence and screening outcomes of hearing assessments in normal and high-risk infants using Otoacoustic Emissions (OAE) and Auditory Brainstem Response (ABR) tests and evaluate their effectiveness in identifying hearing impairment.

Methods: This comparative case-control study was conducted at Superior University, Lahore, with data collected from Hameed Latif Hospital, Lahore. A sample of 292 infants, including normal and high-risk groups, was calculated based on a 95% confidence interval. Newborns underwent OAE screening within the first 24 hours of life, with follow-up screenings at one and two months if the initial result was “refer.” Infants who failed both OAE screenings were subsequently evaluated with ABR testing for diagnostic confirmation of hearing impairment.

Results: The study found a significantly higher incidence of hearing impairment in high-risk infants, with 63.1% (94/149) of high-risk infants referred after the first OAE test compared to 32.2% (46/143) of normal infants. In the second screening, 62.5% of high-risk infants were referred, whereas the normal group showed a refer rate of only 22.4%. Final ABR testing confirmed hearing impairment, showing the OAE and ABR combined protocol to be effective in early detection and confirmation, with notable improvements in developmental outcomes for infants receiving early intervention.

Conclusion: Newborn hearing screening is crucial for the early detection of hearing impairment, particularly in high-risk infants. A protocol combining OAE and ABR testing offers a reliable method for identifying infants who require early intervention, thereby preventing delays in treatment and supporting optimal developmental outcomes. Universal newborn hearing screening programs are recommended to ensure timely identification and intervention for hearing loss.