title: Impact of gestational age on neonatal hearing screening in vaginally-born late-preterm and early-term infants.
abstract: BACKGROUND
  Late-preterm and early-term (LP-ET) infants, defined herein as 35(0)-37(6) weeks' gestation, often fail on 1st otoacoustic emissions (OAE) test.
  
  
  OBJECTIVE
  LP-ET infants fail more than term infants (38(0)-42 weeks' gestation) on the 1st OAE test. Aim : To evaluate the effect of gestational age on the 1st OAE test.
  
  
  METHODS
  We studied 1,572 vaginally-delivered (VD) infants ≥35 weeks' gestation (1.1.2011-30.9.2011). Perinatal and neonatal variables and results of OAE tests were recorded.
  
  
  RESULTS
  LP-ET infants, compared to full-term infants, had a significantly 2-fold higher need for repeated hearing tests: 80.2 versus 43.3 tests/1,000 neonates, respectively (p = 0.026). Univariate analysis showed that late prematurity and age at 1st OAE were significantly associated with failure on 1st OAE. At age 24-42 h, failure on 1st OAE was 2-fold higher in the LP-ET infants than in full-term infants: 9.4 versus 4.7% (p = 0.02). Risk for failure on 1st OAE was age-dependent: 9-fold higher when 1st OAE was performed at 24-42 h of age (5.3%) versus 0.6% after age 42 h. Multivariate analysis showed that variables that were independently significantly associated with failure on 1st OAE included late prematurity (OR 2.0 (1.1-3.7)) and age at 1st OAE (OR 9.2 (1.2-70.7)).
  
  
  CONCLUSIONS
  Compared to term infants, VD LP-ET infants had 2-fold higher rates of failure on 1st OAE (up to 42 h of life) and needed repeated hearing tests. Failure rates after 42 h become negligible in both groups. In VD LP-ET infants, 1st OAE is better performed after 42 h of age.
authors.affiliation: Department of Neonatology, Meyer Children's Hospital, Rambam Medical Center, Haifa, Israel.
authors.forename: Tatiana
authors.initials: T
authors.lastname: Smolkin
authors.forename: Yasmin
authors.initials: Y
authors.lastname: Anton
authors.forename: Irena
authors.initials: I
authors.lastname: Ulanovsky
authors.forename: Shraga
authors.initials: S
authors.lastname: Blazer
authors.forename: Orna
authors.initials: O
authors.lastname: Mick
authors.forename: Majd I
authors.initials: MI
authors.lastname: Makhoul
authors.forename: Imad R
authors.initials: IR
authors.lastname: Makhoul
mesh_terms: D016009:Chi-Square Distribution; D036861:Delivery, Obstetric; D005260:Female; D005865:Gestational Age; D006309:Hearing; D006320:Hearing Tests; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D015997:Neonatal Screening / Q000379:methods*; D016017:Odds Ratio; D017084:Otoacoustic Emissions, Spontaneous; D011237:Predictive Value of Tests; D047928:Premature Birth; D012189:Retrospective Studies; D012307:Risk Factors; D047929:Term Birth