Benefit and pitfalls of newborn hearing screening.

The importance of universal newborn hearing screening (UNHS) in identifying hearing-impaired infants as early as possible is already well recognized. Transient evoked otoacoustic emissions (TEOAE) have been established as a reliable method for UNHS in full term infants. This is a cross sectional study between April 2003--December 2005. Thirteen thousand five hundred and ninety eight (13,598) newborns were screened for hearing loss with portable otoacoustic emission (OAE) before discharge. The initial coverage rate during the 3 years study period was 85.9% (13,598) with 89.2% (3762), 79.0% (4480) and 90.3% (5356) for 2003, 2004 and 2005 respectively. The mean age when hearing loss was diagnosed using ABR were 3.56 months old, 3.08 months old, and 2.25 months old and 3.01 months old for 2003, 2004, 2005 respectively and it was statistically significant. The defaulter rate at the third stage during the 3 years study period was 35% (21), 15.2% (7) and 18.2% (2) for 2003, 2004 and 2005 respectively. This study showed significant improvement in initial referral rate, coverage rate and age of diagnosis. However, we need to improve on high defaulter rates.

Newborn hearing screening: experience in a Malaysian hospital.

INTRODUCTION: This study aims to determine the prevalence of hearing loss among newborns delivered at Hospital Universiti Kebangsaan Malaysia and to evaluate the usefulness of our hearing screening protocol. METHODS: All infants born in the hospital over a nine-month period, between April to December 2003, were screened for hearing loss with a portable otoacoustic emission (OAE) before discharge. At the age of two months, a second OAE test was repeated on newborns who failed the initial test. Those who failed the second test were re-tested at three months of age. When these infants failed the third OAE test, a brainstem evoked response (BSER) test was performed. RESULTS: During the study period, 4,219 infants were born in the hospital, and 3,762 (89.2 percent) underwent OAE screening. 620 (19.7 percent) of them failed the first screening test, and 506 (81.6 percent) of them came for a second stage-screening test. In the third stage screening at three months of age, only 39 (65 percent) patients turned up. Of these, ten infants passed the OAE test and 29 failed. However, when these infants underwent BSER, 13 had normal BSER and 16 have abnormal BSER. The prevalence of hearing loss in this study was 0.42 percent (16/3,762). CONCLUSION: The large number of defaulters and false-positive results in this study suggest that this pilot hearing-screen programme requires fine-tuning to minimise these problems.