When should automatic auditory brainstem response test be used for newborn hearing screening?

Objectives: The aim of this study was to investigate the referral rate and when automatic Auditory Brainstem Response (aABR) should be used for newborn hearing screening. Methods: The present study enrolled 2933 healthy full-term infants and 176 infants with perinatal risk factors. Hearing screening using Transient Evoked Otoacoustic Emissions (TEOAEs) was performed in newborns for the first time 5 days after birth except perinatal risk factors infants. The TEOAE was repeated to neonates failing to pass at the 15th day after birth. Neonates failing to pass the second TEOAE, repeated the test again at the 30th day after birth. Neonates failing to pass the third TEOAE were referred for the second stage screening using aABR. In addition, neonates with risk factors were tested with aABR directly. Results: In this research, 85 (2.9%) infants who could not pass the TEOAE and 176 infants exposed to perinatal risk factors, underwent the aABR test. In the aABR, 14(7.9%) of 176 infants exposed to perinatal risk factors and 10(11.7%) of 85 infants who could not pass the TEOAE failed to pass. As a result, hearing loss was detected in only 10 (0.34%) of 2933 healthy full-term infants. Conclusion: TEOAE should be performed at least twice in healthy full-term infants before aABR, because aABR is to be performed by specially trained personnel and takes a long time. In view of these results, it is our opinion that infants without perinatal risk factors should undergo TEOAE screening test and infants who did not pass control screening tests and have perinatal risk factors should absolutely undergo aABR test. But it should be remembered that TEOAE can cause a problem to miss auditory neuropathy in infants without perinatal risk factors. (C) 2014 Elsevier Ireland Ltd. All rights reserved.