title: Risk indicators for congenital and delayed-onset hearing loss.
abstract: OBJECTIVE
  To evaluate risk indicators for congenital and delayed onset hearing loss in a cohort of newborns who underwent newborn hearing screening, and to evaluate the impact of use of the Joint Committee on Infant Hearing (JCIH) recommendations on requirements for ongoing monitoring of infants identified as at risk for hearing loss.
  
  
  METHODS
  Cohort of 26,341 newborns entered in a prospectively collected database as part of the University of Michigan Universal Newborn Hearing Screening program, with 90 patients identified. Logistic regression analysis was used to evaluate putative risk indicators for congenital and delayed onset hearing loss. An estimate of the cost burden of ongoing monitoring imposed by the use of differing risk indicators was performed.
  
  
  RESULTS
  After controlling for the impact of other risk indicators, intensive care unit length of stay greater than 5 days and exposure to loop diuretics are not associated with an increased risk of congenital or delayed onset hearing loss. Inclusion of these risk indicators as a requirement for ongoing audiologic monitoring results in a high monitoring cost per additional case identified.
  
  
  CONCLUSIONS
  This study confirms that the majority of the risk indicators currently recommended by the JCIH are effective at identifying infants at increased risk of congenital and delayed onset hearing loss. However, use of neonatal intensive care unit length of stay greater than 5 days and exposure to ototoxic medications are associated with small gains in the number of infants correctly identified as at risk of hearing loss. Further evaluation of the utility of these risk indicators, preferably with a diversity of patient population and healthcare settings, is warranted.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, U.S.A.
authors.forename: Casey T
authors.initials: CT
authors.lastname: Kraft
authors.forename: Suparna
authors.initials: S
authors.lastname: Malhotra
authors.forename: Angelique
authors.initials: A
authors.lastname: Boerst
authors.forename: Marc C
authors.initials: MC
authors.lastname: Thorne
mesh_terms: D000617:Aminoglycosides / Q000627:therapeutic use*; D001299:Audiometry / Q000191:economics; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D034381:Hearing Loss / Q000151:congenital / Q000191:economics / Q000453:epidemiology*; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data*; D007902:Length of Stay / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D015997:Neonatal Screening; D018570:Risk Assessment; D012307:Risk Factors; D049994:Sodium Potassium Chloride Symporter Inhibitors / Q000627:therapeutic use*
chemical_list: D000617:Aminoglycosides; D049994:Sodium Potassium Chloride Symporter Inhibitors