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.