Newborns at risk of sensorineural hearing loss in low-income countries

Abstract

Objective: To identify factors placing newborns at risk of sensorineural hearing loss (SNHL) in hospital settings and evaluate their usefulness for targeted screening where resources for universal newborn hearing screening are limited.

Method: Correlates of pre-discharge screen failure following two-stage universal hearing screening with transient-evoked otoacoustic emissions and automated auditory brainstem response were explored in a tertiary maternity hospital in Lagos, Nigeria.

Results: 4115 (88.7%) of 4641 eligible babies were enrolled and of the 3927 who completed screening, 127 (3.2%) failed. Emergency caesarean section, vaginal delivery, 5 min Apgar scores <5 and hyperbilirubinaemia requiring phototherapy emerged as independent risk factors after multivariable logistic regression. While the model's overall discriminative power was low (c statistic = 0.583), the combination of low 5 min Apgar scores and hyperbilirubinaemia requiring phototherapy as possible pre-screening tools showed high specificity (90.7%) and negative predictive value (97.0%).

Conclusion: Factors associated with the risk of SNHL are of limited predictive value but may guide primary prevention initiatives and serve as pre-screening tools in poorly-resourced settings.