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: 4115 (88.7%) of 4641 eligible babies were enrolled and of the 3927 who completed screening, 127 (3.2%) failed. Emergency caesarean section, vaginal delivery, 5 min 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 min 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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Funding: The instruments for this project were provided by Oticon Foundation, Denmark, Natus Medical Inc., USA and Otodynamics (UK) Ltd. The data management software was donated by the National Center for Hearing Assessment and Management (NCHAM), USA. Training support was received from the NHS Newborn Hearing Screening Programme/MRC Hearing and Communication Group, UK. Educational materials for parents and health professionals were sponsored by the Education Trust Fund (ETF), an agency of the Federal Government in Nigeria. None of the sponsors was involved in the study design, collection, analysis and interpretation of data; the writing of the manuscript; or the decision to submit these results for publication.
Competing interests: None.
Ethics approval: Ethics approval was obtained from University College London, UK and Lagos State Health Management Board, Nigeria.
Patient consent: Parental consent obtained.
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