Abstract
Background: The prevalence of hearing impairment among NICU graduates is 2-4%.Unidentified hearing impairment at birth can adversely affect speech and language development and can cause long term behavioural difficulties.. Newborn hearing screening has helped to identify hearing impairment at an early age and has helped children with deafness to make exceptional progress to acquire spoken language.
Aims: The present study aims to find out the prevalence of hearing impairment in newborns admitted to the NICU and to determine the risk factors for hearing loss.
Settings and Design: NICU of Govt. medical college, Kozhikode, Kerala, Descriptive study
Methods and Materials: 902 inborn babies admitted to NICU of Govt. medical college, Kozhikode, Kerala, were evaluated for hearing impairment as part of the universal screening program. The babies were subjected to hearing screening tests (OAE/BERA) and the related risk factors were assessed.
Results: Among the 486 newborns with one or more risk factors in the sample, 20 babies were found to have hearing impairment. The risk factors considered were prematurity, birth weight less than 1500gm, birth asphyxia, mechanical ventilation, use of ototoxic drugs, sepsis, meningitis, craniofacial anomalies, syndromes associated with hearing loss and intrauterine infections.17 babies with hearing loss had 3 or more risk factors.
Conclusions: The most common risk factors in our study were the use of ototoxic drugs, prematurity, very low birth weight and low APGAR score. Use of ototoxic medicines and very low birth weight was found to be significant risk factors for hearing impairment. The study revealed that hearing impairment was more common in neonates with multiple risk factors. Early detection of hearing impairment helped in referring these newborns for trial of a hearing aid and follow up.
References
- American Academy of Pediatrics Task Force on newborn and infant hearing. 1999;103(2):527-529
- US Preventive Services Task Force. Universal screening for hearing loss in newborns: Recommendation statement. Pediatrics.2008;122(1):143
- Kawashiro N, Tsuchihashi N, Koga K, et al. Delayed post neonatal intensive care unit hearing disturbance. Intenational Journal of Paediatric Otorhinolaryngology.1996;34: 35-43.
- Kumar S, Mohapatra B. Status of newborn hearing screening program in India. International journal of pediatric otorhinolaryngology. 2011 Jan 31;75 (1):20-6.
- socialsecuritymission.gov.in/sruthitharangam
- Beswick R, Driscoll C, Kei J, et al. Which risk factors predict postnatal hearing loss in children? Jam Acad Audiol.2013 Mar; 24(3):205-213 Vohr BR, Widen IE, Cone-Wesson B, et al. Identification of neonatal hearing impairment: characteristics of infants in the neonatal intensive care unit and well- baby nursery. Ear Hear. 2000; 21(5):373-382.
- Paul AK. Early identification of hearing loss and centralized newborn hearing screening facility-the Cochin experience Indian pediatrics. 2011 May 1;48(5):355-
- Centralised NBHS,EKM
- Declau F, AA Boudewayns, Jenneke Van deu Ende, Peters A. Etiologic and audiologic evaluations after universal neonatal hearing screening: analysis of 170 referred neonates. 2008;121:1119-1126
- Van Dommelen P, Verkerk PH, Van Straaten HL, Hearing Screening Working Group. Hearing loss by week of gestation and birth weight in very preterm neonates. The Journal of pediatrics. 2015 Apr 30;166(4):840-3.
- Kraft CT, Malhotra S, Boerst A, Thorne MC. Risk indicators for congenital and delayed onset hearing loss. Otol Neurotol 2014 Dec;35(10):1839-1843.
- Vohr BR, Widen IE, Cone-Wesson B, et al. Identification of neonatal hearing impairment: characteristics of infants in the neonatal intensive care unit and well- baby nursery. Ear Hear. 2000; 21(5):373-382.
- Ribeiro GE, da Silva DP, Montovani JC. Transient evoked otoacoustic emissions and auditory brainstem response in infants with perinatal asphyxia. International Journal of Pediatric Otorhinolaryngology. 2016 Oct 31;89: 136-9.
- Alaee E, Sirati M, Taziki MH, et al. Risk factors for sensorineural hearing loss among high risk infants in golestan province, Iran in 2010-2011. Iran Red Crescent Med J. 2015 Dec 20; 17(12): e20419.
- Maqbool M, Najar BA, Gattoo I, Chowdhary J. Screening for Hearing Impairment in High Risk Neonates: A Hospital Based Study. Journal of clinical and diagnostic research: JCDR. 2015 Jun;9(6):SC18.
- Bener A, Eihakeem AA, Abdulhadi K. Is there any association between consanguinity and hearing loss. Int J Pediatr Otorhinolaryngol 2005; 69(3):327- 333.
- Borkoski-Barreiro SA, Falcón-González JC, Limiñana-Cañal JM, Ramos-Macías Á. Evaluation of Very Low Birth Weight (≤ 1500g) as a Risk Indicator for Sensorineural Hearing Loss. Acta Otorrinolaringologica (English Edi). 2013 Dec31;64(6):403-8.
Corresponding Author
Dr Gireesh S
Associate Professor, Department of Paediatrics,
Government Medical College, Kozhikode, Kerala, India