title: [Do infants treated in the neonatal intensive care unit need multi-stage, universal hearing screening testing?].
abstract: BACKGROUND
  The universal hearing screening program has special value for neonatal intensive care unit (NICU) patients because of the multiple risk factors of hearing loss they are subjected to.
  
  
  OBJECTIVE
  To summarize the results of hearing tests on consecutive stages of the screening program and to evaluate the value of hearing loss factors.
  
  
  METHODS
  The group included 851 infants born between 1.10.2006 - 31.12.2009 and treated in the NICU of the University Children's Hospital in Cracow, Poland. Infants with abnormal screening test results (TEOAE) and/or with hearing loss risk factors, or absent from the first stage of the test were qualified for the next stage hearing diagnostics (TEOAE+ABR). Multivariate logistic regression was used in order to evaluate hearing loss risk factors.
  
  
  RESULTS
  679 (80%) newborns were screened by the first stage hearing test. 579 (68%) were tested on the second level diagnostics. 60 patients are still under control. 11/519 (2.1%) had hearing impairment (sensorineual or mixed). 10 had bilateral and 1 had unilateral hearing impairment. The family history was negative for congenital hypoacusis. 1st minute Apgar score < 4 points, congenital TORCH infections and craniofacial anomalies were independent risk factors of hearing loss, however it was not possible to predict more than 2/11 patients with hearing loss based on these factors. Patients with abnormal result of the first stage test had lower birth weight and gestation age than that with normal result. The sensitivity of the first TEOAE test was 82%, specificity 70%, PPV 6.2%, NPV 99%.
  
  
  CONCLUSIONS
  Hearing impairment was rarely a complication of treatment in the NICU, although it was 10 times more frequent in comparison to the whole newborn population. Because the sensitivity, specificity and PPV of first hearing test is not satisfactory, next stage diagnostics in the audiology department are strongly recommended.
authors.affiliation: Klinika Chorób Dzieci, Uniwersytecki Szpital Dzieciecy w Krakowie. tomek.tomasik@gmail.com
authors.forename: Tomasz
authors.initials: T
authors.lastname: Tomasik
authors.forename: Janusz
authors.initials: J
authors.lastname: Godek
authors.forename: Przemko
authors.initials: P
authors.lastname: Kwinta
authors.forename: Beata
authors.initials: B
authors.lastname: Kusak
authors.forename: Jacek J
authors.initials: JJ
authors.lastname: Pietrzyk
mesh_terms: D001299:Audiometry; D034381:Hearing Loss / Q000175:diagnosis*; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D015997:Neonatal Screening; D011044:Poland