ISSN - 0973-0958

Pediatric Oncall Journal View Article

Early detection of Hearing Impairment in High Risk New-borns
Shrabani Mandal1, Mukut Banerjee1, Pulakendu Ghosh2, Asim Kumar Mallick1, Sumana Kanjilal3.
1Department of Pediatrics, NRS Medical College & Hospital, Kolkata, India,
2Health Service, Sagar Rural Hospital, South 24 parganas, India,
3Department of Pediatrics, SSKM Hospital, Kolkata, India.
Aim: To determine risk factors of hearing impairment in high risk neonatal intensive care unit (NICU) graduates.
Methods and Material: This hospital-based prospective observational study was conducted in the NICU graduates of a tertiary center of eastern India from June 2014 to May 2015. Our study population included 130 infants of which 65 were with high-risk factors (hypoxic-ischemic encephalopathy stage II and III, neonatal hyperbilirubinemia, neonatal sepsis/meningitis, and prematurity) and another 65 normal term infants, who had no adverse perinatal clinical events. Brainstem Evoked Response Audiometry (BERA) was performed by Auditory Evoked Potential Machine before one month of age. Those infants who failed to pass the test were asked for repeat testing after 3 weeks of their initial testing. Follow up of the high-risk babies was done at 1 month, 3 months, 6 months, 9 months and at one year. Factors such as birth weight, gender, days of neonatal intensive care unit (NICU) stay and effects on BERA were analyzed.
Results: Out of 65 cases, 15 (23.07%) had birth asphyxia, 20 (30.76%) had hyperbilirubinemia, 10 (15.38%) cases were neonatal sepsis/ meningitis and 20 (30.76%) were of gestational age <37 weeks. On initial BERA screening, 8 (53.33%) cases of birth asphyxia, 9 (45%) cases of hyperbilirubinemia, 2 (20%) cases of sepsis/meningitis and 6 (30%) premature babies had abnormal BERA results of which 3 (4.61%) cases had persistent BERA abnormality after a period of 1 year of follow up of which 3 (4.61%) cases had persistent BERA abnormality after a period of 1 year of follow up. Out of those 3 babies, 2 had severe birth asphyxia with encephalopathy and one had gestational age <37 weeks with other risk factors. Out of 65 controls, no BERA abnormality was detected. In patients with hyperbilirubinemia who had received only one exchange transfusion, abnormal BERA was seen in 3 (23%) on initial screening whereas those who had received 2 exchange transfusion, abnormal BERA was seen in 6 (85.7%) (p=0.03). Similarly, in 15 premature babies with associated risk factors (apnea, hypoglycemia, hypocalcemia, prolonged oxygen use), abnormal BERA was seen in 5 (33.33%) and in 5 premature babies without other risk factors,1 (20%) had abnormal BERA (p=0.001) on initial screening.
Conclusion: Neonates with high-risk factors should have their hearing screening done by the age of one month and confirmation by 3 months and intervention by 6 months of age.

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