title: Hearing impairment and its risk factors by newborn screening in north-western India.
abstract: BACKGROUND
  To screen the newborn by Transient evoked Otoacoustic emission and to assess the incidence of hearing damage and associated risk factors.
  
  
  METHODS
  This longitudinal prospective observational study was conducted at a tertiary care hospital in India. A total of 415 babies were included in the study. All the newborns were evaluated with Transient evoked Otoacoustic emission (TEOAE) which was done by age of 1-3 days. Auditory brain stem response audiometry (AABR) was performed at the age of three months for confirming the hearing loss in the neonates those who failed the TEOAE screening. For infants proven to have significant hearing loss in one or both ears, were denoted to an ear, nose, and throat specialist for further evaluation & rehabilitation.
  
  
  RESULTS
  Out of total 415 babies included in the study, 22 neonates showed abnormal TEOAE examination. Out of these 22 neonates, hearing loss was confirmed in 18 (82 %) subjects. by AABR. The following antenatal and post-natal risk factors were associated with hearing loss: ante-partum bleeding, history of maternal blood transfusion, fetal distress, prematurity, severe birth asphyxia, NICU admission for more than 24 h and Apgar score less than five at 5 min.
  
  
  CONCLUSIONS
  Late identification of hearing loss presents a substantial public health burden. Early recognition and intervention prior to 6 months of age has a significant positive impact on development. A high incidence of hearing impairment seen in our study neonatal population warrants the urgent implementation of universal hearing screening of all the newborn infants in India. NICU infants admitted for more than 24 h are to have an auditory brainstem response (AABR) included as part of their screening so that neural hearing loss will not be missed.
authors.affiliation: Kothari Hospital and Research Center, Bikaner, Rajasthan India.
authors.forename: Zia Ul Haq
authors.initials: ZU
authors.lastname: Gouri
authors.affiliation: Department of Pediatrics, Pt B.D. Sharma PGIMS, Rohtak, Haryana India.
authors.forename: Deepak
authors.initials: D
authors.lastname: Sharma
authors.affiliation: Department of Paediatrics, S.P. Medical College, Bikaner, Rajasthan India.
authors.forename: Pramod Kumar
authors.initials: PK
authors.lastname: Berwal
authors.affiliation: Department of Pediatrics, Government Medical College, Jammu, India.
authors.forename: Aakash
authors.initials: A
authors.lastname: Pandita
authors.affiliation: Department of Obstetrics and Gynaecology, Fernandez Hospital, Hyderabad, India.
authors.forename: Smita
authors.initials: S
authors.lastname: Pawar
keywords: Auditory brain stem response audiometry (AABR); Hearing impairment risk factor; Newborn screening; Transient evoked Otoacoustic emission (TEOAE)