ABR hearing screening for high-risk infants.
OBJECTIVE
The goals of this investigation were to determine the outcome of a high-risk newborn auditory brainstem response hearing screening program at this institution and to determine the clinical characteristics of the target population with special emphasis on the relationship between risk criteria and hearing status.


METHODS
This study involved the prospective screening of newborns with risk indicators and a retrospective analysis of results accumulated over a 10-year period.


METHODS
The study was conducted either in the newborn nursery or outpatient audiology clinic of a tertiary health care center.


METHODS
Patients were 2,103 newborns presenting with one or more risk indicators for significant congenital hearing loss or delayed onset/progressive sensorineural hearing loss.


METHODS
Diagnostic interventions involved auditory brainstem response screening at two intensity levels (25 dB and 65 to 75 dBnHL).


METHODS
The main outcome measure was incidence of significant, nonmedically treatable hearing loss in this population. A secondary outcome measure was determination of incidence of hearing loss in association with different risk indicators.


RESULTS
One hundred fourteen (5.4%) infants were diagnosed with bilateral hearing loss. Twenty-three infants (1%) presented with unilateral hearing loss. Sixty seven (49%) of the 137 infants diagnosed with hearing loss presented with greater than moderate hearing loss. Nine (13.4%) of these 67 patients presented with delayed onset hearing loss that was diagnosed at appointments subsequent to the initial screening. The largest percentage of diagnosed hearing loss was found in the "craniofacial anomalies" category.


CONCLUSIONS
Auditory brainstem response hearing screening of newborns at risk for significant hearing loss is a clinically efficient and cost effective approach to early detection of significant hearing loss. For this program, the calculated cost to diagnose one hearing impaired infant from this population is $3000.
Van Riper
L A
LA
Department of Otolaryngology, Head and Neck Surgery, University of Michigan Medical Center, Ann Arbor 48109, USA.
Kileny
P R
PR
D001927:Brain Diseases / Q000150:complications; D015331:Cohort Studies; D016057:Evoked Potentials, Auditory, Brain Stem / Q000502:physiology*; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D008297:Male; D015997:Neonatal Screening; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors