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Newborns at risk of sensorineural hearing loss in low-income countries
  1. Bolajoko O Olusanya (boolusanya{at}aol.com)
  1. Institute of Child Health and Great Ormond Street Hospital for Children NHS Trust, Nigeria

    Abstract

    Objective: To identify factors placing newborns at risk of sensorineural hearing loss (SNHL) in hospital-settings and evaluate their usefulness for targeted screening where resources for universal newborn hearing screening are limited.

    Method: Correlates of pre-discharge screen failure following two-stage universal hearing screening with transient-evoked otoacoustic emissions and automated auditory brainstem response were explored in a tertiary maternity hospital in Lagos, Nigeria.

    Results: A total of 4,115(88.7%) from 4,641 eligible babies were enrolled. Of the 3,927 who completed screening, 127(3.2%) failed. Emergency caesarean-section, vaginal delivery, 5-minute Apgar scores <5 and hyperbilirubinaemia requiring phototherapy emerged as independent risk factors after multivariable logistic regression. While the model’s overall discriminative power was low (c-statistic=0.583), the combination of low 5-minute Apgar scores and hyperbilirubinaemia requiring phototherapy as possible pre-screening tools showed high specificity (90.7%) and negative predictive value (97.0%).

    Conclusion: Factors associated with the risk of SNHL are of limited predictive value but may guide primary prevention initiatives and serve as pre-screening tools in poorly-resourced settings.

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