Delayed first otoacoustic emissions test decreases failure on neonatal hearing screening after caesarean delivery

作者：Smolkin Tatiana; Awawdeh Sharehan; Blazer Shraga; Mick Orna; Makhoul Imad R^*

来源：Acta Paediatrica, 2013, 102(5): e194-e199.

DOI：10.1111/apa.12175

• Automated auditory brainstem response
• Caesarean delivery
• Otoacoustic emissions
• Universal newborn hearing screening
• Vaginal delivery

Aim Caesarean delivery (CD) was associated with a 3.2-fold higher failure on 1st otoacoustic emissions (OAE) hearing test. We aimed to verify whether postponing 1st OAE beyond 48h in CD infants decreases hearing screening failure. Methods We compared two groups of CD infants as to failure on 1st OAE test: early-1st OAE (n=560): 1st OAE at 12- to 48-h-olds and late-1st OAE (n=566): 1st OAE at 48- to 132-h-olds. Results Compared with early-1st OAE group, the failure rate among late-1st OAE infants was significantly sixfold lower (20.5% vs. 3.4%), with sixfold lower need for repeated tests: 205 vs. 34 tests/1000 CD neonates (p%26lt;0.001). The failure rate decreased with increasing age in both groups (p%26lt;0.001). Univariate analysis: timing of 1st OAE (late vs. early) was significantly associated with failure on 1st OAE. Multivariable analysis: late (48132h) 1st OAE test was associated with a 7.7-fold lower risk for failure of 1st OAE, OR (95% CI): 0.13 (0.080.21). Conclusion Among CD infants, the risk for failure in late-1st OAE group (%26gt;48h) was 7.7-fold lower, with a sixfold lower need for repeated hearing tests. Delaying 1st OAE in CD infants beyond 48h of age (preferably between 48 and 132h) decreases neonatal OAE screening failure.

• 出版日期2013-5