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Hearing Screening in the Neonatal Intensive Care Unit: Follow-Up of Referrals

Washington University School of Medicine, St. Louis, MO

Roanne K. Karzon

Washington University School of Medicine, St. Louis Children's Hospital, St. Louis, MO

Carole C. Mange

St. Louis Children's Hospital, St. Louis, MO

Contact author: Judith E. Cho Lieu, Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, One Children's Place, Room 3S 35, St. Louis, MO 63110. Email: lieuj{at}ent.wustl.edu

PURPOSE: The goal of this study was to examine the rate of diagnostic testing after newborn hearing screening (NHS) referral, evaluate timeliness of follow-up, and evaluate the use of multilevel auditory brainstem response (ABR) in screening of high-risk infants.

METHOD: Telephone interviews were conducted with parents of infants who had been admitted to a neonatal intensive care unit from 1999 to 2002 and referred on NHS. An ABR screen was combined with a multilevel ABR (40, 70, and 90 dB nHL) for referrals.

RESULTS: Parents of 206 infants participated; 69% of the infants underwent diagnostic follow-up. Of those with follow-up, 37% had normal hearing, 38% had hearing loss, and parents were unsure of hearing test results for 25%. Follow-up by 6 months of age occurred for 13% in 1999, increasing to 31% by 2002. Infants who did not pass their screening in both ears had confirmed hearing loss in 56% vs. 25% in those who passed in 1 ear. Also, 67% of infants with bilateral pass levels of 90 dB nHL or more had confirmed hearing loss, vs. 32% in all others.

CONCLUSIONS: Timely follow-up after NHS referral in our program has improved over time. Multilevel ABR may facilitate allocation of appropriate resources to track and ensure follow-up in infants at high risk for hearing loss.

Key Words: newborn hearing screening, hearing loss, auditory brainstem response

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