Automated auditory brainstem response in hearing screening of 4833 newborns

Objective To investigate the significance of automated auditory brainstem response (AABR) technique in newborn hearing screening and the high-risk factors of newborns hearing disturbance.Methods From March 1,2009 to October 31,2011,4961 newborn infants were born in the Department of Obstetrics,Daping Hospital,the Third Military Medical University,among which 4833 cases received preliminary hearing screening by AABR (Algo3i equipment) at 48-72 h after birth.Those who failed in the preliminary screening received secondary screening at 30-42 d after birth.Those who failed again were referred to further investigations for final diagnosis.The gestational age,gender,body weight,body length,delivery mode,Apgar score and whether to be hospitalized in neonatal intensive care unit (NICU) of each newborn were recorded.The association between each factor and hearing screening passing rate was analyzed.Chi-square test was used to compare the results of different groups.Results (1) The preliminary screening rate was 97.4 ％(4833/4961) with a passing rate of 90.3％ (4362/4833).Four hundred and seventy-one infants did not pass the preliminary screening (77 cases for both ears,154 cases for right ear and 240 cases for left ear),among which 33 infants were lost in follow-up.The secondary screening rate was 93.0％ (438/471) with a passing rate of 91.3％ (400/438).(2) Thirty-eight infants did not pass the secondary screening,among which 18 cases rejected to receive further examination,and 12 cases showed normal and 8 cases were diagnosed as hearing disturbance by further examination.The sensitivity and false positive rate of preliminary screening with AABR were 8/8 and 8.7％ (418/4780)respectively.The total false positive rate of both preliminary and secondary screening were 0.4％(18/4780).The detection rate of hearing disturbance was 1.67‰ (8/4788).(3) In preliminary screening,the passing rate of infants with asphyxia was lower than that of those without asphyxia [79.4％ (27/34) vs 90.3％ (4335/4799),x2 =4.577,P＜0.05].The passing rate of left ears was lower than that of right ears [93.4％ (4516/4833) vs 95.2％ (4602/4833),x2 =14.307,P＜0.05].The passing rate of infants who were admitted to NICU was lower than those who were not [46.9％(113/241) vs 92.5％ (4249/4592),x2 =542.336,P＜0.05].No significance of the passing rate of preliminary screening was found in different body weight,delivery modes,genders,gestational ages and body length groups (P＞0.05).Conclusions AABR can be an effective way in newborn hearing screening.History of asphyxia and NICU hospitalization are high-risk factors of hearing disturbance in newborn infants. Key words: Evoked potentials, auditory, brain stem;  Hearing;  Hearing disorders;  Neonatal screening