Hearing Screening And Follow-Up Of Newborns At Different Gestational Ages In Chenzhou In2017

Background and objectives: Congenital hearing disorder is a common birth defect with an incidence of 1 per thousand and 3 per thousand live births in China.Early detection and treatment of hearing loss by Universal Newborn Hearing Screening(UNHS)reduces or eliminates the harm to children caused by congenital hearing loss.In this study,we aimed to determine the relation of gestational ages and hearing loss by retrospectively analyzing the results of hearing screening of neonates at different gestational ages in Chenzhou,which lays a base for further characterization of the risks of hearing loss in newborns and improves the prognosis and quality of life in infants with hearing loss.Subjects and methods: A total of 628 newborn infants who failed in the primary hearing screening and then underwent hearing detection in the Hearing Detection Center of Chenzhou,Affiliated hospital of Xiangnan University were selected by using the cluster sampling method between January 2017 and December 2017.The primary hearing screening,conducted within 2 to 3 days after the birth of the newborn,was carried out in the hearing screening institution of the birthplace.The hearing of newborns was screened by otoacoustic emission(OAE)under a quiet environment or natural sleep and re-screened with either automatic auditory brainstem response(AABR)or distortion product otoacoustic emission(DPOAE).The infants who failed to pass the re-screening cannot bedefinitely diagnosed without further investigation at the age of 3 months,such as diagnostic auditory brainstem response(ABR),40 Hertz auditory event-related potential(AERP),audito steady-state response(ASSR),diagnostic OAE and other methods.For those with severe hearing loss,it is necessary to exclude the presence of anatomic variation and congenital lesions by imaging examination.The infants with mild to moderate hearing loss and negative imaging findings will re-examine audiological detection after 6 months of age.The results of hearing re-screening and the re-examine after 6 months of age were compared and statistically analyzed.Children confirmed with the severe hearing loss were given hearing AIDS or/and cochlear implant for intervention.Children with mild or moderate hearing loss need to have a hearing detection again at 9 months of age and treatment is based on the comparison of results at different gestational ages.Results: In this study,a total of 628 newborns were included in the hearing detection,and 344 of them passed the hearing re-screening.The passing rate is 54.78%.There was no significant statistical difference between different gender(P>0.05).When comparing the follow-up results of the 284 newborns who failed in the primary test,there was significant statistical difference between different gestational ages(P<0.01).The pass rate of newborns whose gestational age between 28 weeks and 37 weeks was 55.17%.There were 100 children with mild to moderate hearing loss who did not pass the re-examination at the age of 6 months.All the 100 children underwent a hearing follow-up examination at the age of 9 months.The passing rate of the follow-up examination at 9 months of age was77.00%,and there was no significant statistical difference between different genders(?2=0.231,P>0.05).When comparing the results of follow-up neonates,there was a significant statistical difference between different gestational ages(?2=10.803,P<0.05).The pass rate at9-month-old follow-up examination was 80.21% for newborns whose gestational ages between 28 to 37 weeks and 80.00% for those between 37 to 42 weeks.All of the children whose gestational age beyond 42 weeks did not pass the hearing examination at 9 months.Conclusion: Hearing loss was correlated with the gestational age of neonates.The passing rate of hearing screening in premature infants group was lower than that in the term infant group,which was speculated to be correlated with underdevelopment of auditory organs and auditory centers due to the preterm fetal age.It is causious to take intervention measures with children who have mild to moderate hearing loss at 6 months of age,given that hearing loss might be improved with the growth of age according to the follow-up till 9 months of age.The hearing recovery was obvious in premature infants,and some of them even restored to completely normal.Therefore,children who fail to pass the re-screening at the age of 6 months can follow-up till the age of 9 months to avoid excessive early intervention.