Targeting risk factors for false-positive outcomes in newborn hearing screening: a focus on mode of delivery - a case-control study

PurposeOtoacoustic emission (OAE) is a widely utilized method for screening newborns for congenital hearing loss. While OAE-based screening has high sensitivity, it is associated with high false-positive rates when conducted shortly after birth. Previous studies found that infants delivered by cesarean section show higher false-positive rates. Nonetheless, other modes of delivery have not been investigated to date. This study aims to evaluate the impact of maternal, neonatal, and perinatal factors on hearing screening false-positive results.MethodsThis retrospective study included 5,621 infants with normal hearing. Infants were divided into two groups: those who failed the initial OAE hearing screening were assigned to the study group, and those who passed were assigned to the control group. Maternal, neonatal, and perinatal factors were extracted from medical records and analyzed to assess possible associations with failing the initial OAE screening.ResultsA total of 365 out of 5621 (6.5%) neonates failed the initial OAE hearing screening. The study group had a higher prevalence of infants delivered by elective or emergency cesarean section, as well as by vacuum-assisted delivery, compared to the control group. Multivariate analysis showed that the mode of delivery had a significant effect on false-positive results, with odds ratios of 15.5, 7.2, and 8.6 for infants born by elective cesarean section, emergency cesarean section, and vacuum delivery, respectively, compared to vaginal delivery.ConclusionInfants delivered by cesarean section or vacuum extraction have higher odds of failing the initial OAE screening when conducted within 48-72 h after birth. Further research is needed to determine the optimal timing for hearing screening.