Influence of postconceptional age on universal newborn hearing screening in NICU-babies

Discrepancies in Management of Congenital Cytomegalovirus in Preterm Infants: An International Survey

We performed an international survey regarding management of infants with congenital cytomegalovirus (cCMV) born at less than 32 weeks gestation or with birth weight under 1500 g. Replies from 51 level 3 neonatal intensive care units across 13 countries demonstrated striking discrepancies in screening practices, testing for cCMV, further investigations of confirmed cases, indications for initiation, and duration of treatment.

Risk factors for hearing impairment in neonates in South Africa: scoping the context for newborn hearing screening planning

PURPOSE

The current study aimed to describe the medical case history factors in a group of neonates admitted to high care and Kangaroo Mother Care wards at two hospitals in Gauteng, South Africa and to explore the relationship between specific case history factors and audiological outcomes.

METHODS

This study was part of a bigger study titled "Early detection of hearing loss: exploring risk-based hearing screening within a developing country context" where all case history data were recorded from participant medical files at the time of an initial hearing screening, through the use of a case history form that was developed for this study. Results were analyzed using descriptive statistics. The relationship between case history factors and audiological outcomes was analyzed using Fisher's exact test.

RESULTS

Findings revealed that, of all the case history data, preterm birth (95.7%), exposure to ototoxic medication (87.7%), neonatal jaundice (NNJ) (80.6%), and birthweight below 1500 g (66.7%) were the most frequently occurring case history factors in this South African sample. No statistically significant association was found between these frequently occurring case history factors and the repeat hearing screening outcomes in this sample.

CONCLUSIONS

Risk factors for hearing impairment cannot be viewed in isolation but should be considered in relation to their interaction with multiple other risk factors. Contextually understanding the profile of high risk has implications for medical intervention, as well as for the field of Audiology where planning for early identification and intervention services for hearing impairment is vital. Such contextually relevant evidence allows for a snap shot of how this population presents, what their needs and requirements are, and their possible future requirements; hence, raising important planning implications for the department of health and for targeted newborn hearing screening as well as early childhood intervention within the South African context.

Newborn hearing screening and early diagnostic in the NICU

The aim was to describe the outcome of neonatal hearing screening (NHS) and audiological diagnosis in neonates in the NICU. The sample was divided into Group I: neonates who underwent NHS in one step and Group II: neonates who underwent a test and retest NHS. NHS procedure was automated auditory brainstem response. NHS was performed in 82.1% of surviving neonates. For GI, referral rate was 18.6% and false-positive was 62.2% (normal hearing in the diagnostic stage). In GII, with retest, referral rate dropped to 4.1% and false-positive to 12.5%. Sensorineural hearing loss was found in 13.2% of infants and conductive in 26.4% of cases. There was one case of auditory neuropathy spectrum (1.9%). Dropout rate in whole process was 21.7% for GI and 24.03% for GII. We concluded that it was not possible to perform universal NHS in the studied sample or, in many cases, to apply it within the first month of life. Retest reduced failure and false-positive rate and did not increase evasion, indicating that it is a recommendable step in NHS programs in the NICU. The incidence of hearing loss was 2.9%, considering sensorineural hearing loss (0.91%), conductive (1.83%) and auditory neuropathy spectrum (0.19%).