Prediction of permanent hearing loss in high-risk preterm infants at term age

The aim of this series was to assess hearing screenings; auditory brainstem responses (ABR), transient evoked otoacoustic emissions (TEOAE) and free f ield auditory responses (FF) for the prediction of permanent bilateral hear ing loss in high-risk preterm infants at term post-conceptional age. A tota l of 51 preterm infants (gestational age <34 weeks, birth weight <1500 g) u nderwent examinations at term and hearing, speech and neurological developm ent were followed up until a corrected age of 18 months. Significant hearin g defects were verified by broader ABR examinations under sedation and by c linical ward observation including responsiveness to sounds and enhancement of hearing using an amplification device. Seven bilateral fails in ABR wer e found, together with nine bilateral fails in TEOAE and four fails in FF s creening at term age. Six preterm infants were later confirmed to have a si gnificant permanent bilateral hearing loss, four of whom had also cerebral palsy. Bilateral failure in ABR screening predicted hearing loss with a sen sitivity of 100% and a specificity of 98%, TEOAE with a sensitivity of 50% and a specificity of 84% and in the FF examination at the levels of 50% and 98%, respectively. Conclusion Transient evoked otoacoustic emissions alone seem not to be so a pplicable to the neonatal screening of hearing in high-risk preterm infants as shown earlier in fullterm infants, possibly because a hearing defect ma y be due to retrocochlear damage. Consequently, auditory brainstem response screening seems to be more suitable for very low birth weight preterm infa nts.