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Thangavelu K, Martakis K, Feldmann S, Roth B, Lang-Roth R. Referral rate and false-positive rates in a hearing screening program among high-risk newborns. Eur Arch Otorhinolaryngol 2023; 280:4455-4465. [PMID: 37154942 PMCID: PMC10477105 DOI: 10.1007/s00405-023-07978-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 04/11/2023] [Indexed: 05/10/2023]
Abstract
AIM More studies exploring referral rates and false-positive rates are needed to make hearing screening programs in newborns better and cost-effective. Our aim was to study the referral and false-positivity rates among high-risk newborns in our hearing screening program and to analyze the factors potentially associated with false-positive hearing screening test results. METHODS A retrospective cohort study was done among the newborns hospitalized at a university hospital from January 2009 to December 2014 that underwent hearing screening with a two-staged AABR screening protocol. Referral rates and false-positivity rates were calculated and possible risk factors for false-positivity were analyzed. RESULTS 4512 newborns were screened for hearing loss in the neonatology department. The referral rate for the two-staged AABR-only screening was 3.8% with false-positivity being 2.9%. Our study showed that the higher the birthweight or gestational age of the newborn, the lower the odds of the hearing screening results being false-positive, and the higher the chronological age of the infant at the time of screening, the higher the odds of the results being false-positive. Our study did not show a clear association between the mode of delivery or gender and false-positivity. CONCLUSION Among high-risk infants, prematurity and low-birthweight increased the rate of false-positivity in the hearing screening, and the chronological age at the time of the test seems to be significantly associated with false-positivity.
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Affiliation(s)
- Kruthika Thangavelu
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Marburg, Philipps-Universität Marburg, Baldingerstrasse, 35043, Marburg, Germany.
| | - Kyriakos Martakis
- Department of Pediatric Neurology, Social Pediatrics and Epileptology, Justus-Liebig-University Giessen and University Hospital Giessen, Feulgenstr. 10-12, 35392, Giessen, Germany
- Department of Pediatrics, Faculty of Medicine and University Hospital Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
| | - Silke Feldmann
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
| | - Bernhard Roth
- Department of Neonatology, Faculty of Medicine and University Hospital Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
| | - Ruth Lang-Roth
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
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Abstract
Hearing loss is one of the most common congenital defects in infancy; it increases speech and language delays and adversely affects academic achievement and socialemotional development. The risk of hearing loss in premature infants is higher than that in normal newborns, and because of the fragility of the auditory nervous system, it is more vulnerable to different risk factors. The hearing screening guidelines in current use were proposed by the American Academy of Pediatrics and updated in 2007, but there are no uniform guidelines for hearing screening in preterm infants. This review focuses on the risk factors related to hearing loss in premature infants, hearing screening strategies, and reasons for failure. The aim is to provide a more comprehensive understanding of hearing development in preterm infants to achieve early detection and early intervention. At the same time, attention should be paid to delayed auditory maturation in preterm infants to avoid excessive intervention. KEY POINTS: · Hearing loss is very common in infancy, especially in premature infants.. · Genetic factors, infection, hyperbilirubinemia, drugs, and noise are the main causes.. · We should pay attention to the delayed hearing maturity of premature infants and avoid excessive intervention..
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Affiliation(s)
- Xiaodan Zhu
- Division of Neonatology, Department of Pediatrics, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China.,Department of Perinatology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China.,Sichuan Clinical Research Center for Birth Defects, Luzhou, Sichuan, China
| | - Xiaoping Lei
- Division of Neonatology, Department of Pediatrics, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China.,Department of Perinatology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China.,Sichuan Clinical Research Center for Birth Defects, Luzhou, Sichuan, China
| | - Wenbin Dong
- Division of Neonatology, Department of Pediatrics, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China.,Department of Perinatology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China.,Sichuan Clinical Research Center for Birth Defects, Luzhou, Sichuan, China
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Seo G, Choi HG, Jang S, Choi S, Lee SR, Park SK. Analysis of the Referral Rates of Newborn Hearing Screening Test According to Childbirth Delivery Methods in Neonatal Care Units. J Clin Med 2021; 10:jcm10132923. [PMID: 34210006 PMCID: PMC8268358 DOI: 10.3390/jcm10132923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 06/13/2021] [Accepted: 06/27/2021] [Indexed: 12/02/2022] Open
Abstract
It is known that neonates born by cesarean delivery (CD) may have higher referral rates than those born by vaginal delivery (VD) for newborn hearing screening (NHS). False-positive NHS results can increase costs and parental anxiety. This study analyzed the differences in NHS referral rates according to delivery methods in Level I, II, and III neonatal care units. A retrospective chart review was done for 2322 infants (4644 ears) with delivery records who underwent NHS between 2004 and 2017. The first NHS was performed immediately before discharge when the infant was in good condition via the automated auditory brainstem response (AABR) or automated otoacoustic emissions (AOAE). There were 98 neonates (196 ears) who underwent both AABR and AOAE simultaneously as the first NHS, 30 of which failed. We used a total of 4810 ears in this analysis. Of all enrolled ears, 2075 ears were of neonates born by CD, and 2735 ears were of neonates born by VD. A total of 2460 ears were from patients in Level III neonatal intensive care units (NICU) and 2350 ears were from Level I and II neonatal care units. The overall referral rate was higher in infants born via CD (4.5%) than VD (3.2%). In Level I and II neonatal intensive care units, the referral rate was significantly higher in those born via CD (3.0%) than via VD (1.4%). Further, based on the screening method, AABR (75.8%) was more frequently used than AOAE (24.2%), thereby revealing AABR’s higher referral rate in CD (2.9%) than in VD (1.2%). The referral rate of infants who underwent the NHS within three days of birth was higher in the CD group (3.0%) than in the VD group (1.3%). There was no significant difference in the referral rate depending on the delivery method when infants were hospitalized for more than four days or hospitalized in the NICU. The referral rate according to the delivery methods was significantly higher when the NHS test was performed for healthy newborns in the Level I and II neonatal care units born by CD within 72 h using AABR. Therefore, we recommend that the hearing screening test for newborns delivered by cesarean section be performed after 72 h of age. The results of this study may reduce the false-positive NHS results, unnecessary further tests, and parental anxiety.
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Affiliation(s)
- Ganghyeon Seo
- Department of Otorhinolaryngology-Head and Neck Surgery, Kangnam Sacred Heart Hospital, Hallym University, College of Medicine, 1, Singil-ro, Yeongdeungpo-gu, Seoul 07441, Korea; (G.S.); (S.J.); (S.C.)
| | - Hyo Geun Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Hallym Sacred Heart Hospital, Hallym University, College of Medicine, 22, Gwanpyeong-ro 170beon-gil, Dongan-gu, Anyang 14068, Korea;
| | - Sookyung Jang
- Department of Otorhinolaryngology-Head and Neck Surgery, Kangnam Sacred Heart Hospital, Hallym University, College of Medicine, 1, Singil-ro, Yeongdeungpo-gu, Seoul 07441, Korea; (G.S.); (S.J.); (S.C.)
| | - Sun Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Kangnam Sacred Heart Hospital, Hallym University, College of Medicine, 1, Singil-ro, Yeongdeungpo-gu, Seoul 07441, Korea; (G.S.); (S.J.); (S.C.)
| | - Sa Ra Lee
- Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan, College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea
- Correspondence: (S.R.L.); (S.-K.P.); Tel.: +82-2-3010-3648 (S.R.L.); +82-2-829-5217 (S.-K.P.); Fax: +82-2-3010-3630 (S.R.L.); +82-2-842-5217 (S.-K.P.)
| | - Su-Kyoung Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Kangnam Sacred Heart Hospital, Hallym University, College of Medicine, 1, Singil-ro, Yeongdeungpo-gu, Seoul 07441, Korea; (G.S.); (S.J.); (S.C.)
- Correspondence: (S.R.L.); (S.-K.P.); Tel.: +82-2-3010-3648 (S.R.L.); +82-2-829-5217 (S.-K.P.); Fax: +82-2-3010-3630 (S.R.L.); +82-2-842-5217 (S.-K.P.)
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Kadirogullari P, Yalcin Bahat P, Karabuk E, Bagci Cakmak K, Seckin KD. Effect of analgesia with pethidine during labour on false positivity of newborn hearing screening test. J Matern Fetal Neonatal Med 2021; 35:6254-6259. [PMID: 33882796 DOI: 10.1080/14767058.2021.1910661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Newborn hearing screening may fail due to some perinatal and neonatal factors. False positivity of newborn hearing screening increases costs, familial concerns and anxiety. The objective of this study was to determine the effects of pethidine administered in the mother for labor analgesia on the false positivity rates of the newborn hearing screening test. METHODS This study was designed as a retrospective and cross-sectional study. A total of 75 pregnant women scheduled for vaginal delivery who received 50 mg intramuscular pethidine at the beginning of the active phase of the labor were included as the patient group and 68 pregnant women who did not receive pethidine as the control group. A total of 143 infants born with vaginal delivery were evaluated with otoacoustic emission (OAE) test before discharge. Perinatal and neonatal variables and test outcomes were recorded, and the correlation between false positivity rate and pethidine usage was evaluated. RESULTS Initially, system records of 148 healthy term newborns were screened. Four patients who failed in both OAE tests and were referred to the Automated Auditory Brainstem Response (AABR) test and one patient who failed in all tests (first OAE, control OAE and AABR) and was referred to an upper center for further investigations and treatment were excluded from the study. No statistically significant difference was found between the groups in terms of birth features. First stage OAE test was reported as 'passed' in 8 (10.7%) and 58 (85.3%) newborns in the study and control groups, respectively; while OAE was reported as 'referred' and 'passed' in the second test in 67 (89.3%) and 10 (14.7%) newborns in the study and control groups, respectively. There was a statistically significant difference between both groups in terms of false positivity ratio (p < 0.5). CONCLUSION Pethidine significantly decreases the duration of the active phase, providing a good analgesic effect for pain management during labor. Therefore, it seems that pethidine can be used as an acceptable agent during labor. However, it may have neonatal effects after the delivery, causing false positivity in newborn hearing screening tests. The results of this study support the opinion that the OAE test should be performed in postpartum later dates in order to increase OAE passing rates and minimize costs and parents' concerns.
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Affiliation(s)
- Pinar Kadirogullari
- Department of Obstetrics and Gynecology, Acıbadem University Atakent Hospital, Istanbul, Turkey
| | - Pinar Yalcin Bahat
- Department of Obstetrics and Gynecology, Kanuni Sultan Suleyman Research and Training Hospital, Istanbul Health Sciences University, Istanbul, Turkey
| | - Emine Karabuk
- Department of Obstetrics and Gynecology, Acıbadem University Atakent Hospital, Istanbul, Turkey
| | - Kubra Bagci Cakmak
- Department of Obstetrics and Gynecology, Kanuni Sultan Suleyman Research and Training Hospital, Istanbul Health Sciences University, Istanbul, Turkey
| | - Kerem Doga Seckin
- Department of Obstetrics and Gynecology, Kanuni Sultan Suleyman Research and Training Hospital, Istanbul Health Sciences University, Istanbul, Turkey
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Al-Balas HI, Nuseir A, Zaitoun M, Al-Balas M, Khamees A, Al-Balas H. The effects of mode of delivery, maternal age, birth weight, gender and family history on screening hearing results: A cross sectional study. Ann Med Surg (Lond) 2021; 64:102236. [PMID: 33868678 PMCID: PMC8040126 DOI: 10.1016/j.amsu.2021.102236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 03/12/2021] [Accepted: 03/18/2021] [Indexed: 11/24/2022] Open
Abstract
Introduction Congenital hearing impairment is one of the principal issues that make distress to families especially those with a family history of hearing problems. Early detection of hearing impairment can make a difference regarding cognitive, attention, learning, speech, and social and emotional development of babies. Otoacoustic test emission is a very common screening test that can be used to pick up early cases and relieve family stress. We tried to evaluate the factors that may disrupt our results regarding the OAE test. Methods A cross-sectional study included infants who were admitted to the nursery unit alone. Infants who were admitted to the NICU unit, infants with craniofacial anomalies, infants with vernix in the external auditory canal, and Infants with Stigmata associated with a syndrome known to include a sensorineural hearing loss were excluded from the study. Both transient evoked otoacoustic emissions (TEOAE) with distortion product otoacoustic emissions (DPOAE) Screening tests were performed by the same professional audiologist experienced in neonatal screening. Results A total of 1413 newborns (733 males and 680 females) were included in the study. Among them, 1368 babies (96.8%) passed the first OAE in both ears, while 45 babies (3.2%) didn't pass the first OAE in one or both ears.Significant correlations between the female gender and family history of congenital hearing loss with failure of the first OAE test results. Moreover, vaginal delivery (VD) infants had a 1.5-fold higher failure rates of first OAE test screening results in comparison to caesarian delivery (CD) infants. Conclusion Our study demonstrated higher failure rates of the first OAE in female infants, vaginal delivery infants, and infants with a family history of hearing impairment. It is recommended to postpone the first phase of hearing screening for those infants until the first scheduled vaccine appointment to achieve higher compliance attendance, and decrease family stress associated with false-negative results of the test. Hearing impairment is a stressful condition that disturbs family quality of life. Early detection of hearing impairment can make a difference in child development. Otoacoustic test emission is a screening test with considerable reliability. Early Otoacoustic test can have false negative results in specific condition. Postpone the first phase of hearing screening decrease the family stress.
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Affiliation(s)
| | - Amjad Nuseir
- Department of Special Surgery, Faculty of Medicine, Jordan University of Science and Technology, Jordan
| | - Maha Zaitoun
- Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Jordan
| | - Mahmoud Al-Balas
- Department of General and Special Surgery, Faculty of Medicine, Hashemite University, Zarqa, Jordan
| | | | - Hamzeh Al-Balas
- Department of General and Special Surgery, Faculty of Medicine, Hashemite University, Zarqa, Jordan
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Stuart A. Effect of delivery mode on neonate auditory brainstem responses to air- and bone-conducted stimuli. Int J Pediatr Otorhinolaryngol 2020; 139:110423. [PMID: 33035804 DOI: 10.1016/j.ijporl.2020.110423] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 09/30/2020] [Accepted: 09/30/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVES The object of this study was to examine if caesarean section delivered neonates have different middle ear function relative to neonates with vaginal delivery. METHODS Auditory brainstem responses (ABRs) were examined in caesarean section delivered (n = 23) and vaginally delivered (n = 29) neonates. ABRs were also evoked with air- and bone-conducted stimuli (i.e., clicks and CE-Chirps) and presented at a screening intensity level (i.e., 30 dB nHL). Wave V latencies and amplitudes were examined as a function of mode of delivery and stimuli. RESULTS Statistically significant longer wave V latencies evoked with air-conducted stimuli were seen in caesarean section delivered neonates (p = .042). There was no statistically significant difference in wave V latencies with bone-conducted stimuli among the two groups of neonates (p = .42). There were no significant differences in wave V amplitude between neonates with caesarean section and vaginal delivery for air-conducted (p = .42) stimuli. Wave V amplitudes were not significantly different as a function of mode of delivery with CE-Chirp stimulus (p = .41). Wave V amplitudes were significantly larger for the caesarean section delivered neonates with the bone-conducted click stimulus (p = .036). CONCLUSIONS The ABR wave V latency disparity with air- and bone-conducted stimuli support the notion that differences in middle ear function exist between the two groups of newborns. It was speculated that delayed fluid resorption in the middle ear exists in neonates with caesarean section delivery compared to those with vaginal delivery.
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Affiliation(s)
- Andrew Stuart
- Department of Communication Sciences and Disorders, 3310 Health Science Bldg-CSDI-MS 668, East Carolina University, Greenville, NC, 27858-4353, USA.
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Yakıştıran B, Karslı M, Canpolat E, Oğuz Y, Altınboğa O, Celen S. The Effect of Anesthesia Type During Delivery on Neonatal Otoacoustic Emission Hearing Test Results: A Tertiary Center Experience. Z Geburtshilfe Neonatol 2020; 225:262-266. [PMID: 32992403 DOI: 10.1055/a-1253-8727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Hearing is essential for the healthy development of an infant as language is one of the main stimulants of intellectual capacity. We investigate the effect of anesthesia type during delivery on neonatal otoacoustic emission (OAE) hearing test results. METHODS This retrospective cross-sectional study includes 1,493 healthy, full-term (39/0-40/6 gestational weeks) newborns of healthy women and who were delivered by cesarean section. Newborns were divided into 2 groups based on their anesthesia type during delivery: 1) general anesthesia group (n=160), and 2) spinal anesthesia group (n=1333). Maternal age, anesthesia type, birth weight, gestational age at birth, neonatal gender, 1st-5th minute APGAR scores, and OAE results were compared between the groups. RESULTS 1287 (86.2%) newborns were reported to have passed the first step of OAE; 206 (13.8%) newborns were reported to have failed the first step and passed the second test. In the general anesthesia group, 133 (83.1%) of the newborns passed the first OAE test and 27 (16.9%) newborns had false-positive results. In the spinal anesthesia group, 1,154 (86.6%) of the newborns passed the first OAE test and 179 (13.4%) newborns had false-positive results. The difference between the 2 groups by false-positive values was found to be statistically significant (p<0.001). CONCLUSIONS Type of delivery anesthesia may have an effect on the false-positive rates of OAE test results.
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Affiliation(s)
- Betül Yakıştıran
- Division of Perinatology, Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital
| | - Mehmet Karslı
- Obstetrics and gynecology, Istanbul Universitesi-Cerrahpasa, Istanbul, Turkey
| | - Emre Canpolat
- Neonatology, Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Yüksel Oğuz
- Obstetrics and gynecology, Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Orhan Altınboğa
- Division of Perinatology, Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital
| | - Sevki Celen
- Obstetrics and gynecology, Etlik İhtisas Eğitim ve Araştırma Hastanesi, Ankara, Turkey
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Comparison of hearing screening results of Syrian refugees and Turkish newborns. Int J Pediatr Otorhinolaryngol 2020; 135:110095. [PMID: 32422369 DOI: 10.1016/j.ijporl.2020.110095] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 05/05/2020] [Accepted: 05/05/2020] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To analyze Turkish (Host) and Syrian (Refugee) newborn hearing screening results and factors of risk. METHODS All newborns between 02.12.2017 and 31.06.2019 were screened with Automated Auditory Brainstem Response (AABR) test. A total of 874 newborns were examined (172 refugee and 702 host newborns). All screened patients were questioned in terms of consanguineous marriage, speech disorder in family, delivery method (normal vaginal birth/caesarean birth), birth weight, birth week, newborn intensive care unit (ICU) necessity, newborn icterus and phototherapy. RESULT As for the host newborns, 360 (51.3%) passed ABR screening, 161 (23%) failed in either one ear, and 181 (25.8%) failed both ears. As for the refugee newborns, 60 (34.9%) passed ABR screening, 38 (22.1%) failed in either one ear, and 74 (43.0%) failed both ears. There was a significant statistical difference between host and refugee newborns' ears in terms of hearing loss detected in the screening test (p = 0.017). In terms of delivery method, the caesarean rate was higher in refugees, and a statistically significant difference existed between two groups (p = 0.023). There was a significant difference between refugee newborns and host newborns in terms of newborn ICU necessity rate (p = 0.014). CONCLUSIONS It was demonstrated clearly that hearing screening test results between the two groups were affected by low socio-economic level when host and refugees newborns were compared. In line with the findings of this study, it should be taken into account that bad living conditions depending on war and immigration throughout pregnancy, delivery method, and the need for newborn ICU in the newborn period may affect hearing results in newborns significantly.
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Oghan F, Guvey A, Topuz MF, Erdogan O, Guvey H. Effects of vaginal birth versus caesarean section on hearing screening results in a large series from the Aegean region. Int J Audiol 2019; 59:310-315. [PMID: 31777297 DOI: 10.1080/14992027.2019.1696994] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objective: To evaluate the effects of caesarian section (CS) versus vaginal birth (VB) delivery techniques on results from neonatal hearing screening tests (NHSTs).Design: Retrospective analysis.Study sample: A total of 10,767 neonates divided into two groups according to delivery technique underwent NHSTs. Those who failed TEOAE or AABR were sent for diagnostic ABR examination.Results: A total of 5620 of 6044 (92.9%) of the neonates in the CS group passed the TEOAE test bilaterally and 424 (7.1%) failed either unilaterally or bilaterally. In the VB group, 4496 of 4723 (95.1%) neonates passed the TEOAE test bilaterally, while the remaining 227 (4.9%) failed the test either unilaterally or bilaterally. Bilateral passing rate of TEOAE test results was significantly higher in the VB group than the CS group (p < 0.05). The AABR failure rate (unilaterally or bilaterally) was 1% in the CS group, which was significantly higher than that in the VB group (0.6%). Diagnostic ABR bilateral pass rate was not statistically different between the groups.Conclusions: Delivery method was shown to affect the results of NHSTs. We found that the rates of failing the TEOAE and screening AABR examinations were higher among neonates born by CS compared to VB.
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Affiliation(s)
- Fatih Oghan
- ENT Clinic, KSBU, Evliya Celebi Egitim Arastirma ve Hastanesi, Kutahya, Turkey
| | - Ali Guvey
- ENT Clinic, KSBU, Evliya Celebi Egitim Arastirma ve Hastanesi, Kutahya, Turkey
| | | | - Onur Erdogan
- ENT Clinic, KSBU, Evliya Celebi Egitim Arastirma ve Hastanesi, Kutahya, Turkey
| | - Huri Guvey
- Obstetrics and Gynecology Clinic, KSBU, Evliya Celebi Egitim Arastirma ve Hastanesi, Kutahya, Turkey
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Zhou H, Ding Y, Yang Y, Zou S, Qu X, Wang A, Wang X, Huang Y, Li X, Huang X, Wang Y. Effects on developmental outcomes after cesarean birth versus vaginal birth in Chinese children aged 1-59 months: a cross-sectional community-based survey. PeerJ 2019; 7:e7902. [PMID: 31660274 PMCID: PMC6815197 DOI: 10.7717/peerj.7902] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Accepted: 09/16/2019] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVE It is controversial whether the mode of delivery is associated with developmental outcome, and little was known about growth and development of cesarean children in poor rural areas in China. We aim to measure the development of both cesarean and vaginal-delivered children by Ages and Stages Questionnaires (ASQ) and explore the association between mode of delivery and developmental outcome in poor rural areas in China. METHODS Data were collected from a cross-sectional community-based survey, which recruited 1,755 vaginal delivered and cesarean children ages 1 to 59 months in eight counties of China. Caregivers of those children completed the Chinese version of ASQ-3 (ASQ-C) while physical examination andquestionnaires on socio-demographic and neonatal characteristics were conducted. Multivariate logistic regressions were used to measure the association between developmental delay and mode of delivery as well as each socio-demographic factor, respectively, after adjusting other socio-demographic characteristics. RESULTS The prevalence of suspected overall developmental delay was 23.4% in the cesarean group, compared with 21.3% in the vaginal delivered group, yet without statistical difference (p < 0.05). Developmental delay was also not significantly different between cesarean and vaginal delivered group in five ASQ domains of communication (7.7% vs. 7.8%, p = 0.949), fine motor (7.0% vs. 6.1%, p = 0.538), gross motor (8.5% vs. 6.4%, p = 0.154), problem solving (7.2% vs. 6.7%, p = 0.722) and personal social (8.0% vs. 7.9%, p = 0.960). CONCLUSIONS Our findings suggest that cesarean delivery does not increase or decrease the risk of suspected developmental in children delay as compared with vaginal delivery.
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Affiliation(s)
- Hong Zhou
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
- Environmental and Spatial Epidemiology Research Center, National Human Genetic Resources Center, Beijing, China
| | - Yuan Ding
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | | | - Siyu Zou
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Xueqi Qu
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Anqi Wang
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States of America
| | - Xi Wang
- Children’s Hospital of Philadelphia, Philadelphia, PA, United States of America
| | - Yue Huang
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Xintong Li
- Beijing Camford Royal School, Beijing, China
| | | | - Yan Wang
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
- Environmental and Spatial Epidemiology Research Center, National Human Genetic Resources Center, Beijing, China
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Güven SG. The Effect of Mode of Delivery on Newborn Hearing Screening Results. Turk Arch Otorhinolaryngol 2019; 57:19-23. [PMID: 31049248 DOI: 10.5152/tao.2019.3940] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Accepted: 01/15/2019] [Indexed: 11/22/2022] Open
Abstract
Objective Congenital hearing loss is one of the most important public health problems with a frequency of about 1-6 per 1000 live births all over the world. Although neonatal hearing screening tests are important for the timely detection and rehabilitation of hearing loss, determining the factors that may affect the screening results will contribute greatly to the development of screening programs. In this study, the effects of the modes of delivery on the results of tests in the screening program was investigated. Methods In this study, the results of 10.575 newborns who were screened according to the National Neonatal Hearing Screening Protocol between January 2013 and May 2017 were evaluated. The screening test results of 2.653 newborns were examined retrospectively according to the type of delivery after candidates were excluded according to the exclusion criteria and risk factors for hearing loss. Of these newborns, 1.571 (59.2%) were born by normal delivery and 1.082 (40.8%) by cesarean section. Screening test results were analyzed using Pearson's Chi-square test. Results No statistically significant difference was observed among the 2.653 neonatal hearing screening test results in terms of mode of delivery (p>0.05). In both delivery modes, the rate of false positive was found to be high (81.9%) in the first hearing screening test of newborns, and this rate decreased in the second screening test (14.5%). Conclusion The mode of delivery has no significant effect on the neonatal hearing screening results; however, the observation that neonates had been more successful in the second screening test in both groups suggests that the test protocol should be re-evaluated in terms of timing.
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Affiliation(s)
- Selis Gülseven Güven
- Department of Otorhinolaryngology, Trakya University School of Medicine, Edirne, Turkey
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Johnson LC, Toro M, Vishnja E, Berish A, Mills B, Lu Z, Lieberman E. Age and Other Factors Affecting the Outcome of AABR Screening in Neonates. Hosp Pediatr 2018; 8:141-147. [PMID: 29472244 DOI: 10.1542/hpeds.2017-0060] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
BACKGROUND Although the utility of universal newborn hearing screening is undisputed, testing protocols vary. In particular, the impact of the infant's age at the time of automated auditory brainstem response (AABR) screening has not been well studied. METHODS We conducted a retrospective review of newborn hearing screening data in 6817 low-risk, term and late-preterm newborns at our large, urban, academic medical center for a 1-year period to analyze the impact of age and other factors on the screening failure rate and referral for diagnostic testing. RESULTS AABR screening failure rates decreased with postnatal age over the first 48 hours; 13.3% failed at <24 hours versus 3.8% at ≥48 hours (P < .0001). Infants who were initially tested at ≥36 hours failed repeat testing more often than those who were tested at <36 hours (11.5% vs 18.9%; P = .03). Other factors that were associated with failure included being a boy and of a race other than white. Sensorineural hearing loss (SNHL) was diagnosed in 18.6% of infants who failed their final screening at ≥48 hours compared with 2.8% of those whose final screening occurred earlier (P = .03). SNHL was more likely in infants who failed their first screening bilaterally (21.2%) than unilaterally (4.4%); P = .03). CONCLUSIONS Among healthy newborns, delaying AABR screening in the first 48 hours minimized failure rates. SNHL was 6 times as likely in infants who failed their final screening at ≥48 hours compared with those who were screened at <48 hours of age. In our study, we offer guidance for nursery directors and audiologists who determine hearing screening protocols and counsel families about results.
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Affiliation(s)
- Lise Carolyn Johnson
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | | | | | | | | | - Zhigang Lu
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Ellice Lieberman
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, Massachusetts
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Mallen JR, Hunter JB, Auerbach C, Wexler L, Vambutas A. Characterization of newborn hearing screening failures in multigestational births. Int J Pediatr Otorhinolaryngol 2018; 105:158-162. [PMID: 29447805 DOI: 10.1016/j.ijporl.2017.12.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 12/13/2017] [Accepted: 12/14/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To define the rate and characterize the type of newborn hearing screening failures in multigestational births. METHODS Retrospective chart review of all multigestational births that occurred in a 10-year period (2002-2012) in which at least one newborn failed newborn hearing screening at two tertiary care hospitals in the Northwell Health System. RESULTS Out of 125,405 total births, we identified 2961 multigestational births, of which 59 (2.0%) newborns failed newborn hearing screening. None of their 66 twin/triplet siblings failed their newborn hearing screens. Of 43 newborns that returned for follow-up, 56.0% (24/43) had confirmed hearing loss, resulting in an overall rate of 0.81% in all multigestational newborns with hearing loss. Of 19 infants that passed repeat testing, two were judged to need myringotomy tube placement. Twenty-four infants had a confirmed hearing loss, 11 of which had sensorineural hearing loss (0.37%), and 13 with a conductive or mixed hearing loss (0.44%). CONCLUSIONS We identified a greater than expected risk of conductive hearing loss, not attributable to otitis media, than sensorineural hearing loss in this population. These observations are consistent with the increased risk of birth defects in multigestational births.
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Affiliation(s)
- Jonathan Ross Mallen
- Department of Otolaryngology, University of Connecticut Health Center, 263 Farmington Ave, Farmington, CT 06030, USA; Zucker School of Medicine at Hofstra/Northwell, 500 Hofstra Blvd, Hempstead, NY 11549, USA.
| | - Jacob B Hunter
- Department of Otolaryngology, Albert Einstein College of Medicine, Greene Medical Arts Pavilion, 3400 Bainbridge Avenue, 3rd Floor, Bronx, NY 10467, USA.
| | - Charles Auerbach
- Department of Social Work, Wurzweiler School of Social Work, Yeshiva University, Yeshiva University Wilf Campus, Belfer Hall, 2495 Amsterdam Avenue, New York, NY 10033, USA
| | - Leslie Wexler
- Department of Otolaryngology, Hofstra-Northwell School of Medicine, 430 Lakeville Rd, New Hyde Park, NY 11040, USA
| | - Andrea Vambutas
- Department of Otolaryngology, Hofstra-Northwell School of Medicine, 430 Lakeville Rd, New Hyde Park, NY 11040, USA; Department of Otolaryngology, Albert Einstein College of Medicine, Greene Medical Arts Pavilion, 3400 Bainbridge Avenue, 3rd Floor, Bronx, NY 10467, USA.
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The Effect of Mode of Delivery and Hospital Type on Newborn Hearing Screening Results Using Otoacoustic Emissions: Based on Screening Age. Indian J Otolaryngol Head Neck Surg 2016; 69:1-5. [PMID: 28239569 DOI: 10.1007/s12070-016-0967-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Accepted: 02/08/2016] [Indexed: 10/22/2022] Open
Abstract
It is well known that false positive on newborn hearing screening increases cost and maternal anxiety and worry. We aimed to evaluate the influence of mode of delivery (cesarean, vaginal) and hospital type (private, public) on false positives first screening test based on screening age. Identification and control of these factors can reduce the rate of false positives. Overall, 2784 infants were evaluated by otoacoustic emissions test. Hearing screening test was performed before hospital discharge. Finally, rate of the false-positive between both delivery group and hospital types were compared on the basis of screening age. False-positive results are obtained when a condition is not present, but the test results indicate that it is present. False positive rate in the first screening test in vaginal delivery was significantly higher than cesarean delivery and rate of significantly decreased with screening age. This reduction was observed only in cesarean delivery. Also the rate of false positives in public hospital is 2.2 fold higher than private hospital (P = 0.000) and with increase in screening age, the rate of False positive is significantly reduced in private hospitals while this decrease is not observed in public hospital. Screening test be retarded as much as possible in cesarean group and private hospital and be conducted just prior to hospital discharge also in public hospital, screening test are done in a separate room. In this way, false positive can be reduced by about six times and the cost and concerns imposed by the rate of false positives minimized.
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Association between mode of delivery and failure of neonatal acoustic emission test: a retrospective analysis. Int J Pediatr Otorhinolaryngol 2015; 79:516-9. [PMID: 25665804 DOI: 10.1016/j.ijporl.2015.01.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Revised: 01/14/2015] [Accepted: 01/19/2015] [Indexed: 01/23/2023]
Abstract
BACKGROUND Infants born by cesarean delivery (CD) appear to fail the otoacoustic emission (OAE) test more frequently than infants delivered vaginally (VD). OBJECTIVE The present study aimed to evaluate the influence of CD on failure to the OAE test in Chinese infants. METHODS In this retrospective study, 1460 Chinese infants were included. The OAE test was performed before hospital discharge. Modes of delivery, test time and OAE results were collected and analyzed. RESULTS Compared with VD infants, CD infants had lower gestational age (week), were smaller for their gestational age (SGA), and presented a lower 1-min Apgar score and a younger age at first OAE. On multivariate analysis, CD and age at first OAE were significantly associated with failed OAE (both P<0.001). CD infants had a 3-fold higher rate of failure to the OAE test compared with VD infants (21% vs. 7.1%). The results of the OAE test changed with different test time regardless of the mode of delivery, and the neonatal OAE test failure rate decreased with time. The difference was not significant between CD and VD infants 42h or more after delivery. CONCLUSION CD infants had significantly higher failure rates on first OAE test. Results suggest that the OAE test should be performed 42h after delivery so as to minimize repetition of OAE, improve the OAE test pass rate, and minimize costs and parents' anxiety.
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