Universal screening of newborns to detect hearing impairment-Is it necessary?

Background: In contrast to the recommendations of the Joint Committee on Infant Hearing, neonatal hearing screening programs are still not universally available. Objectives: To prospectively evaluate the presence of hearing loss in all newborn babies delivered in our hospital during study period using the transient evoked otoactoustic emission as the primary screening tool followed by confirmation with brainstem evoked response audiometry before six months of age and to determine risk factors responsible for hearing loss. Design: A prospective study of nonrandomized cohort. Setting: Nursery, Postnatal ward and NICU of Tertiary care center. Participants: 500 neonates (439: not at risk; 61: at risk) from a total of 610 neonates born in between 2009 and 2010. Measurements: Incidence of hearing impairment in the "at risk" and "no risk" group was compared, using proportion test. Main outcome measure(s): Incidence of hearing loss in newborns both "at risk" and in "no risk" group, risk factors responsible for hearing loss, importance of universal newborn hearing screening. Results: The overall incidence of hearing impairment was 8 per 1000 screened. The incidence in "no risk" and "at risk" group was 2.27 per 1000 screened and 49.18 per 1000 screened respectively. Statistically significant difference in the incidence of hearing impairment between the two groups. (P < 0.05; Proportion Test) was seen. Common risk factors identified were culture positive postnatal infections, birth asphyxia, low birth weight, and prematurity. Conclusions: A high incidence of hearing impairment warrants the implementation of universal newborn hearing screening. Considering the economic limitations of our country we may employ screening of "at risk" groups initially. (C) 2013 Elsevier Ireland Ltd. All rights reserved.