ABR hearing screening for high-risk infants

Objective: The goals of this investigation were to determine the outcome of a high-risk newborn auditory brainstem response hearing screening program at this institution and to determine the clinical characteristics of the ta rget population with special emphasis on the relationship between risk crit eria and bearing status. Study Design: This study involved the prospective screening of newborns wit h risk indicators and a retrospective analysis of results accumulated over a 10-year period. Setting: The study was conducted either in the newborn nursery or outpatien t audiology clinic of a tertiary health care center. Patients: Patients were 2,103 newborns presenting with one or more risk ind icators for significant congenital hearing loss or delayed onset/progressiv e sensorineural hearing loss. Interventions: Diagnostic interventions involved auditory brainstem respons e screening at two intensity levels (25 dB and 65 to 75 dBnHL). Main Outcome Measures: The main outcome measure was incidence of significan t, nonmedically treatable hearing loss in this population. A secondary outc ome measure was determination of incidence of hearing loss in association w ith different risk indicators. Results: One hundred fourteen (5.4%) infants were diagnosed with bilateral hearing loss. Twenty-three infants (1%) presented with unilateral hearing l oss. Sixty seven (49%) of the 137 infants diagnosed with hearing loss prese nted with greater than moderate hearing loss. Nine (13.4%) of these 67 pati ents presented with delayed onset hearing loss that was diagnosed at appoin tments subsequent to the initial screening. The largest percentage of diagn osed hearing loss was found in the "craniofacial anomalies" category. Conclusions: Auditory brainstem response hearing screening of newborns at r isk for significant hearing loss is a clinically efficient and cost effecti ve approach to early detection of significant hearing loss. For this progra m, the calculated cost to diagnose one hearing impaired infant from this po pulation is $3000.