Relationship between Hearing Loss Risk Factors and Hearing Screening Results in Newborns: A Retrospective Cross-Sectional Study

Congenital hearing loss can have a long-term impact on children’s speech and communication abilities. Early detection and intervention of hearing loss are important in newborns. It is well known that there are several risk factors for hearing loss; however, the relationship between these risk factors and hearing screening tests remains uncertain in Iran. Therefore, this study aimed to explore the relationship between hearing loss risk factors and Automated Auditory Brainstem Response (AABR) and Transient-Evoked Otoacoustic Emissions (TEOAEs) within the Iranian context. This retrospective cross-sectional study was conducted on 9622 newborns (4643 females and 4979 males) in Iran. The data related to newborn hearing screening, including gender, the results of initial hearing screening, and hearing loss risk factors, were extracted from newborns’ record files. Data were analyzed using SPSS and a significant level was 0.05%. 190 (3.45%) newborns were referred to the screening. Fourteen newborns were diagnosed with hearing loss (prevalence of hearing loss = 1.45 per 1000) and 9 had one or more risk factors. There was a strong relationship between NICU admission, hyperbilirubinemia, family history of hearing loss, and consanguineous marriage with hearing screening test results (P < 0.05). Among risk factors investigated in this study, hyperbilirubinemia, family history of hearing loss, and intrauterine infections were not significantly correlated with TEOAEs results (P > 0.05). In contrast, they were significantly correlated with AABR results and the lowest OR was for prematurity and the highest for family history of hearing loss. Hyperbilirubinemia, family history of hearing loss, and intrauterine infections were the most significantly correlated risk factors with AABR and family history of hearing loss could be considered as a risk factor that most often leads to AABR failure results in Iran. So, Iranian clinicians, specifically, should ask parents to ask their relatives about any history of hearing loss or other health conditions that may affect their child's health. The findings also provide further evidence supporting the effectiveness of the newborn hearing screening protocols within the Iranian context, which recommend using AABR and TEOAEs tests for infants with risk factors for hearing loss.