Evaluation of Hearing Loss after Failed Neonatal Hearing Screening

Objective: We evaluated the causes of hearing loss found after failed universal newborn hearing screening and compared the results with the previously used behavioral observation test (Ewing/CAPAS). Study design: Hearing loss in neonates, born between September 1999 and October 2007 and referred to our center after failed screening, was determined by audiologic testing and physical examination. Results: In 340 included neonates the results of hearing tests were as follows: normal hearing 21.2%, conductive hearing loss 20.3%, and sensorineural hearing loss (SNHL) 57.9%. Children referred from the neonatal intensive care unit were more at risk of SNHL (71%) than those from the well-baby clinics (54%). Hearing aids were provided at a median age of 8 months. The positive predictive value of SNHL screening was 54% for a child from a well-baby clinic and 71% for a child from the neonatal intensive care unit. Conclusion: The use of universal newborn hearing screening results in a lower proportion of infants positive because of otitis media with effusion than the previously used Ewing/CAPAS test (20% vs 59-81%). Second, screening leads to identification of hearing loss and intervention at a younger age (8 months vs 15-18 months). Third, the positive predictive value for SNHL has improved (54% vs 2%).

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