DOI: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20210677

Hearing impairment among high risk neonates born in a tertiary care hospital in north Kerala: a cross sectional study

Ahsanu Zaman Kunnath, Anwar Sadath Choolakkaparambu Aboobakker, Bashir Nalakath Kunjimon, Sandeep Sreedhar

Abstract


Background: Hearing is necessary for the proper mental and social development of a new-borns child. Delay in diagnosis leads to improper development of social and mental skills. The prevalence of congenital hearing loss is greater than prevalence of screened metabolic syndromes. There are multiple maternal and intrapartum risk factors associated with hearing impairment. Most of the causes are treatable. Objectives was to find out the proportion of hearing impairment in neonates and its risk factors in a tertiary care hospital in north Kerala.

Methods: This cross-sectional research was performed in a tertiary care hospital in Northern Kerala between January 2018 and June 2019 after obtaining informed consent and institutional ethical committee clearance among those who fulfilled the inclusion and exclusion criteria. All the high-risk new-borns were subjected to Otoacoustic examination. Those who did not pass the first OAE were subjected to second OAE after one month. Those who did not pass in the examination were subjected to BERA. Those high risk children who did not pass the BERA were considered having hearing impairment and were subjected to further investigation and appropriate management.   

Results: The prevalence of hearing impairment was 0.5%. 0.25% were unilateral and 0.25% were bilateral. Pregnancy induced hypertension, premature labour, lower segment Caesarian section, low birth weight, small for gestational age, respiratory distress, hyperbilirubinemia and presence of congenital malformations were significantly associated with hearing impairment.  

Conclusions: Since most of the congenital hearing loss among high risk neonates can be treated, a nationwide standardized hearing assessment program is advocated for the early detection of high risk children with hearing loss.


Keywords


High risk neonates, Early hearing loss, Risk factors, Screening

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References


Declau F, Boudewyns A, Van den Ende J, Peeters A, van den Heyning P. Etiologic and audiologic evaluations after universal neonatal hearing screening: analysis of 170 referred neonates. Pediatrics. 2008;121(6):1119-26.

Nagapoornima P, Ramesh A; Srilakshmi, Rao S, Patricia PL, Gore M, Dominic M; Swarnarekha. Universal hearing screening. Indian J Pediatr. 2007;74(6):545-9.

Mehra S, Eavey RD, Keamy DG Jr. The epidemiology of hearing impairment in the United States: newborns, children, and adolescents. Otolaryngol Head Neck Surg. 2009;140:461-72.

Stach BA, RamachandranVS. Hearing disorders in children. In: Madell JR, Flexer C eds. Pediatric Audiology: Diagnosis, Technology, and Management. New York: Thieme Medical Publishers Inc; 2008:3-12.

Judith A, Mason MS, Kenneth R, Herrmann MD. Universal infant hearing screening by automated auditory brainstem response measurement. Pediatrics. 1998;101:221-8

Stewart JE, Knorr A. Hearing loss in neonatal intensive care unit graduates: manual of neonatal care. A Lippincott Manual. 7th ed. 2012;65:846-50.

Yoshikawa S, Ikeda K, Kudo T, Kobayashi T. The effects of hypoxia, premature birth, infection, ototoxic drugs, circulatory system and congenital disease on neonatal hearing loss. Auris Nasus Larynx. 2004;31(4):361-8.

Joint Committee on Infant Hearing; American Academy of Audiology; American Academy of Pediatrics; American Speech-Language-Hearing Association; Directors of Speech and Hearing Programmes in State Health and Welfare Agencies. Year 2000 Position Statement: Principles and guidelines for early hearing detection and intervention programmes. Pediatrics. 2000;106; 798-817.

Roth AD, Hildesheimer M, Maayan-Metzger A, Muchmik C, Hamburger A, Mazkeret R, et al. Low prevalence of hearing impairment among very low birth weight infants as detected by universal neonatal hearing screening. Arch Dis Child Fetal Neonatal. 2006; 91(4):257–62.

Nelson, Cloharty, Rai N, Thakur N. Universal screening of newborns to detect hearing impairment – Is it necessary? Int J Pediatr Otorhinolaryngol. 2013;77:1036-41

Kumar S, Mohapatra B. Status of newborn hearing screening program in India. Int J Pediatr Otorhinolaryngol. 2011;75(1):20-6.

Galhotra A, Sahu P. Challenges and solutions in implementing hearing screening program in India. Indian J CommunityMed 2019;44:299-302.

Kumar RK, Kini P, Sardangouda P, et al. Routine newborn hearing screening – an Indian experience. Int J Pregn & Chi Birth. 2016;1(1):15-7.

Yenamandra KK, SahuPK, Kumar A, Rai N, Thakur PK. Universal hearing screening of newborn to detect hearing loss and aid in early intervention: multicentre study. Int J Contemp Pediatr 2018;5:2114-8.

Fisher DA, Dussault JH, Foley TP, Klein AH, LaFranchi S, Larsen PR, et al. Screening for congenital hypothyroidism: results of screening one million North American infants. J Pediatr. 1979;94:700-5

US Preventive Services Task Force. Universal screening for hearing loss in newborns: Recommendation statement. Pediatrics. 2008;122(1):143

Patel H, Feldman M. Universal newborn hearing screening. Paediatr Child Health. 2011;16(5):301-10.

Kumar S, Mohapatra B. Status of newborn hearing screening program in India. Int J Pediat Otorhinolaryngol 2011;75(1):20-6.

Wood-Jones F, Wen 1-C. The development of the external ear. J Anat 1934;68:525-33.

Harvey Coates and Kim Gifkins. Newborn hearing screening. Aust Prescr 2003;26:82-4

Nair VS, Das P, Soundararajan P. Prevalence and risk factors of hearing impairment among neonates admitted in NICU in a tertiary care centre in South India. Int J Contemp Pediatr 2018;5:1342-7.

James M, Kumar P, Ninan PJ. A study on prevalence and risk factors of hearing Impairment among newborns. Int J Contemp Pediatr. 2018;5:304-9.

Paul AK. Early identification of hearing loss and centralized newborn hearing screening facility-the Cochin experience. Indian J Pediatr. 2011;48(5):355-9.

Yenamandra KK, SahuPK, Kumar A, Rai N, Thakur PK. Universal hearing screening of newborn to detect hearing loss and aid in early intervention: multicentre study. Int J Contemp Pediatr 2018;5:2114-8.

Van Straaten HL. Automated auditory brainstem response in neonatal hearing screening. Acta Paediatr Suppl. 1999;88(432):76-9.

Finitzo T, Albright K, O’Neal J. The newborn with hearing loss: detection in the nursery. Pediatrics 1998;102:1452-60.

Hille E, Van Straaten HL, Verkerk PH. Prevalence and independent risk factors for hearing loss in NICU infants. Acta paediatrica. 2007;96(8):1155-8.

Boskabadi H, Zakerihamidi M, Moradi A, Bakhshaee M. Risk Factors for Sensorineural Hearing Loss in Neonatal Hyperbilirubinemia. Iran J Otorhinolaryngol. 2018;30(99):195-202.

Pourarian S, Khademi B, Pishva N, Jamali A. Prevalence of hearing loss in newborns admitted to neonatal intensive care unit. Iran J Otorhinolaryngol. 2012;24(3):129-34.

Van Dommelen P, Verkerk PH, Van Straaten HL, Hearing Screening Working Group. Hearing loss by week of gestation and birth weight in very preterm neonates. J Pediatrics. 2015;166(4):840-3.

Wroblewska-Seniuk K, Greczka G, Dabrowski P, Szyfter-Harris J, Mazela J. Hearing impairment in premature newborns-Analysis based on the national hearing screening database in Poland. PLoS One. 2017;12(9):e0184359.

Kraft CT, Malhotra S, Boerst A, Thorne MC. Risk indicators for congenital and delayed onset hearing loss. Otol Neurotol 2014;35(10):1839-43.

Jiang ZD. Long-term effect of perinatal and postnatal asphyxia on developing human auditory brainstem responses: peripheral hearing loss. Int J Pediatr Otorhinolaryngol. 1995;33(3):225-38.

Christine Ohl, LilianeE Dornier, Cecile Czajka, Jean-Claude Chobaut and Laurent Tavernier.Newborn hearing screening on infants at risk. Int J Paediat Otorhino Laryngology. 2009;73:1691-5.

De Vries LS, Lary S, Whitelaw AG, Dubowitz LM. Relationship of serum bilirubin levels and hearing impairment in newborn infants. Early Hum Development. 1987;15(5):269-77.

Elaine S Marlow, Linda P Hunt, Neil Marlow. Sensorineural hearing loss and prematurity. Arch Dis Child Fetal Neonatal. 2000;82:F141–4.

Bakhshaee M, Boskabadi H, Hassanzadeh M, Nourizadeh N, Ghassemi MM, Khazaeni K, et al. Hearing impairment in the neonate of preeclamptic women. Otolaryngol Head Neck Surg. 2008;139(6):846-9.

Olds C, Oghalai JS. Audiologic impairment associated with bilirubin-induced neurologic damage. Semin Fetal Neonatal Med. 2015 Feb;20(1):42-46.

Wong AC, Ryan AF. Mechanisms of sensorineural cell damage, death and survival in the cochlea. Front Aging Neurosci. 2015 Apr 21;7:58.