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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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Kaveh M, Mirjalali SN, Shariat M, Zarkesh MR. Perinatal factors influencing the neonatal hearing screening results. BMC Pediatr 2021; 21:15. [PMID: 33407257 PMCID: PMC7786484 DOI: 10.1186/s12887-020-02476-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 12/16/2020] [Indexed: 11/24/2022] Open
Abstract
Background Previous studies have indicated that the majority of cases with “failed” results related to transient evoked otoacoustic emissions (OAE) test have the normal hearing. The present study aimed to assess the possible relationships between perinatal factors and the false-positive OAE results. Methods A case-control study was carried out in an Iranian Hospital in 2020. Based on the OAE results on the first day of life, newborns were divided into 2 groups; Control group included subjects with “Pass” OAE results. Every neonate with “Fail” OAE result was referred for auditory brainstem response (ABR). Neonates with bilateral fail OAE but normal ABR results (false-positive OAE) were considered as the case group. All recorded data were analyzed to assess the possible correlations between maternal/neonatal factors and the false-positive OAE results. Results One hundred and eighty-one neonates entered the study. Of all included neonates, 87 (48.1%) cases showed bilateral fail OAE and 94 (51.9%) subjects passed the OAE test. Normal ABR results (false-positive OAE) were observed in all cases with bilateral fail OAE. Comparisons of variables affecting the OAE results showed that of all perinatal factors, neonate’s sex (p = 0.046) and cesarean section (p = 0.003) were the only influencing factors that increased the risk of false-positive OAE results. Conclusion Based on the results, the cesarean section delivery and neonate’s male sex increased the risk of false-positive results related to OAE test. Implementing other screening tests such as ABR or Automated ABR as the initial screening test could be suggested for such cases.
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Affiliation(s)
- Mahbod Kaveh
- Department of Pediatrics, Bahrami Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mamak Shariat
- Maternal & Child Health Specialist, Maternal, Fetal and Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Zarkesh
- Maternal, Fetal and Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran. .,Department of Neonatology, Yas Women Hospital, Tehran University of Medical Science, Sarv Ave., North Nejatolahi Street, Tehran, 1598718311, Iran.
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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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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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Olarte M, Bermúdez Rey MC, Beltran AP, Guerrero D, Suárez-Obando F, López G, García M, Ospina JC, Fonseca C, Bertolotto AM, Aldana N, Gelvez N, Tamayo ML. Detection of hearing loss in newborns: Definition of a screening strategy in Bogotá, Colombia. Int J Pediatr Otorhinolaryngol 2019; 122:76-81. [PMID: 30978473 DOI: 10.1016/j.ijporl.2019.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 03/13/2019] [Accepted: 03/14/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To describe the results from the hearing screening protocol adopted in a Hospital in Colombia emphasizing the importance of performing screening on an outpatient basis, when the newborn is more than 24 h old. METHODS A prospective study at Hospital Universitario San Ignacio in Bogota, Colombia was carried out, from May 1st, 2016 to Nov 30th, 2017, the study sample included 2.088 newborns examined using transient otoacoustic emissions. RESULTS We obtained written consent from the parents of 1.523 newborns and 24 individuals (1.6%) failed the first stage of the screening, nine cases unilateral and 15 bilateral. A total of nine neonates (0,6%) failed the second screening test, six cases unilateral and three bilateral. Four (0,3%) did not return to the second test. Our false altered screening rate was 0.7%. CONCLUSIONS In a developing country with limited human and economic resources, in which newborn early discharge is the norm, a newborn hearing screening program linked to infants' check-ups, that uses otoacoustic emissions after 48 h of life, seems a feasible option compare to the standard US protocol aiming to conduct hearing screening prior to discharge.
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Affiliation(s)
- Margarita Olarte
- Instituto de Genética Humana, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Carrera 7 # 40-62, Colombia
| | - María Carolina Bermúdez Rey
- Unidad de Otorrinolaringología, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Carrera 7 # 40-62, Colombia
| | - Angela P Beltran
- Instituto de Genética Humana, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Carrera 7 # 40-62, Colombia
| | - Diana Guerrero
- Unidad de Otorrinolaringología, Hospital Universitario San Ignacio, Bogotá, Carrera 7 # 40-62, Colombia
| | - Fernando Suárez-Obando
- Instituto de Genética Humana, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Carrera 7 # 40-62, Colombia; Servicio de Genética, Hospital Universitario San Ignacio, Bogotá, Carrera 7 # 40-62, Colombia
| | - Greizy López
- Instituto de Genética Humana, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Carrera 7 # 40-62, Colombia
| | - Mary García
- Instituto de Genética Humana, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Carrera 7 # 40-62, Colombia
| | - Juan C Ospina
- Unidad de Otorrinolaringología, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Carrera 7 # 40-62, Colombia; Unidad de Otorrinolaringología, Hospital Universitario San Ignacio, Bogotá, Carrera 7 # 40-62, Colombia
| | - Carol Fonseca
- Unidad de Otorrinolaringología, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Carrera 7 # 40-62, Colombia
| | - Ana M Bertolotto
- Servicio de Pediatría, Hospital Universitario San Ignacio, Bogotá, Carrera 7 # 40-62, Colombia; Departamento de Pediatría, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Carrera 7 # 40-62, Colombia
| | - Nubia Aldana
- Instituto de Genética Humana, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Carrera 7 # 40-62, Colombia
| | - Nancy Gelvez
- Instituto de Genética Humana, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Carrera 7 # 40-62, Colombia.
| | - Martha L Tamayo
- Instituto de Genética Humana, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Carrera 7 # 40-62, Colombia
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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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Smolkin T, Awawdeh S, Blazer S, Mick O, Makhoul IR. Delayed first otoacoustic emissions test decreases failure on neonatal hearing screening after caesarean delivery. Acta Paediatr 2013; 102:e194-9. [PMID: 23363315 DOI: 10.1111/apa.12175] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Revised: 01/15/2013] [Accepted: 01/24/2013] [Indexed: 11/30/2022]
Abstract
AIM Caesarean delivery (CD) was associated with a 3.2-fold higher failure on 1st otoacoustic emissions (OAE) hearing test. We aimed to verify whether postponing 1st OAE beyond 48 h in CD infants decreases hearing screening failure. METHODS We compared two groups of CD infants as to failure on 1st OAE test: early-1st OAE (n = 560): 1st OAE at 12- to 48-h-olds and late-1st OAE (n = 566): 1st OAE at 48- to 132-h-olds. RESULTS Compared with early-1st OAE group, the failure rate among late-1st OAE infants was significantly sixfold lower (20.5% vs. 3.4%), with sixfold lower need for repeated tests: 205 vs. 34 tests/1000 CD neonates (p < 0.001). The failure rate decreased with increasing age in both groups (p < 0.001). Univariate analysis: timing of 1st OAE (late vs. early) was significantly associated with failure on 1st OAE. Multivariable analysis: late (48-132 h) 1st OAE test was associated with a 7.7-fold lower risk for failure of 1st OAE, OR (95% CI): 0.13 (0.08-0.21). CONCLUSION Among CD infants, the risk for failure in late-1st OAE group (>48 h) was 7.7-fold lower, with a sixfold lower need for repeated hearing tests. Delaying 1st OAE in CD infants beyond 48 h of age (preferably between 48 and 132 h) decreases neonatal OAE screening failure.
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Affiliation(s)
| | | | | | - Orna Mick
- Audiology Clinic; Rambam Health Care Campus; Haifa; Israel
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Smolkin T, Anton Y, Ulanovsky I, Blazer S, Mick O, Makhoul MI, Makhoul IR. Impact of gestational age on neonatal hearing screening in vaginally-born late-preterm and early-term infants. Neonatology 2013; 104:110-5. [PMID: 23839312 DOI: 10.1159/000350554] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2012] [Accepted: 03/01/2013] [Indexed: 11/19/2022]
Abstract
BACKGROUND Late-preterm and early-term (LP-ET) infants, defined herein as 35(0)-37(6) weeks' gestation, often fail on 1st otoacoustic emissions (OAE) test. HYPOTHESIS LP-ET infants fail more than term infants (38(0)-42 weeks' gestation) on the 1st OAE test. Aim : To evaluate the effect of gestational age on the 1st OAE test. METHODS We studied 1,572 vaginally-delivered (VD) infants ≥35 weeks' gestation (1.1.2011-30.9.2011). Perinatal and neonatal variables and results of OAE tests were recorded. RESULTS LP-ET infants, compared to full-term infants, had a significantly 2-fold higher need for repeated hearing tests: 80.2 versus 43.3 tests/1,000 neonates, respectively (p = 0.026). Univariate analysis showed that late prematurity and age at 1st OAE were significantly associated with failure on 1st OAE. At age 24-42 h, failure on 1st OAE was 2-fold higher in the LP-ET infants than in full-term infants: 9.4 versus 4.7% (p = 0.02). Risk for failure on 1st OAE was age-dependent: 9-fold higher when 1st OAE was performed at 24-42 h of age (5.3%) versus 0.6% after age 42 h. Multivariate analysis showed that variables that were independently significantly associated with failure on 1st OAE included late prematurity (OR 2.0 (1.1-3.7)) and age at 1st OAE (OR 9.2 (1.2-70.7)). CONCLUSIONS Compared to term infants, VD LP-ET infants had 2-fold higher rates of failure on 1st OAE (up to 42 h of life) and needed repeated hearing tests. Failure rates after 42 h become negligible in both groups. In VD LP-ET infants, 1st OAE is better performed after 42 h of age.
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Affiliation(s)
- Tatiana Smolkin
- Department of Neonatology, Meyer Children's Hospital, Rambam Medical Center, Haifa, Israel
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Smolkin T, Mick O, Dabbah M, Blazer S, Grakovsky G, Gabay N, Gordin A, Makhoul IR. Birth by cesarean delivery and failure on first otoacoustic emissions hearing test. Pediatrics 2012; 130:e95-100. [PMID: 22689871 DOI: 10.1542/peds.2011-3179] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Neonatal hearing screening occasionally fails. We noticed that infants born by cesarean delivery (CD) appeared to fail the first otoacoustic emissions (OAE) test more frequently than infants delivered vaginally (VD). This might increase maternal anxiety. We aimed to evaluate the influence of mode of delivery on failure to pass the first OAE. METHODS Overall, 1653 infants of >35 weeks' gestation were evaluated. OAE was performed before discharge. Perinatal-neonatal variables and results of OAE were recorded retrospectively. RESULTS Compared with VD infants, CD infants had lower gestational age and 1-minute Apgar, more small for gestational age (SGA), and earlier age at first OAE. Univariate analysis: CD, male gender, gestational age 35 to 37 weeks, birth weight ≤ 2500 g, SGA, and younger age at first OAE were significantly associated with failed first OAE. In infants weighing 2501 to 4000 g, CD infants had 3-fold higher rates of failed first OAE in comparison with VD infants (20.7% vs 7.1%) before 48 hours of age. In the multivariate analysis, variables independently significantly associated with failed first OAE were male gender (odds ratio [OR] 1.42 [1.02-1.98]), CD (emergency CD: OR 3.18 [2.21-4.57], elective CD: OR 3.32 [2.04-5.42]), age 12 to 23 hours at first OAE (OR 3.1 [2.1-4.58]) and SGA (OR 2.2 [1.15-4.28]). CONCLUSIONS CD infants had significantly higher failure rates on first OAE. We speculate that CD is accompanied by retained fluid in middle ear which may impair neonatal hearing. The timing of first OAE after CD should preferably be postponed beyond 48 hours of age to improve OAE passage and minimize maternal anxiety and costs.
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Affiliation(s)
- Tatiana Smolkin
- Department of Neonatology, Meyer Children’s Hospital, Haifa, Israel.
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