Universal newborn hearing screening using A-TEOAE and A-ABR: The experience of a large public hospital

BACKGROUND: Universal newborn hearing screening (UNHS) aims to identify hearing loss in the early postnatal period; prompt detection of bilateral or unilateral hearing loss is mandatory for timely intervention. METHODS: This retrospective study reports the results of the first two years of a UNHS program on 4,719 newborns in a large public Italian hospital. Screening was divided into two levels: automated transient otoacoustic emissions were used for first level; automated auditory brainstem response for second level. Second level included children with a "refer" response at first level and babies with a family history for hearing loss or other risk factors. Hearing loss diagnosis was made using clinical auditory brainstem response. RESULTS: During first level, 254 (5.4%) newborns were "refer". At retest, 130 (51.1%) babies were PASS and 48 (18.8%) were "refer". 76 babies dropped out (29.9%). 146 babies (3.1%) were referred to the second level: 48 for a "refer" response at first level and 98 for a PASS response but potential hearing loss due to risk factors. 24 babies dropped out (16.4%). Out of 122 newborns tested in the second level, 105 (86.1%) had a PASS response and 17 (13.9%) were "refer". Our screening protocol identified 7 (0.14%) babies with profound hearing loss; 5 had unilateral and 2 had bilateral hearing loss. 2 babies dropped out at diagnostic level (11.8%). CONCLUSIONS: A correct and early diagnosis of hearing loss is mandatory to prevent permanent consequences; the spread of hearing screening programs is the optimal solution to reach this goal.