Efficacy of automated auditory brainstem response hearing screening in very preterm newborns

Objective: To investigate the efficacy of an automated auditory brainstem r esponse (AABR) hearing screening method in very preterm newborns in the neo natal intensive care setting. Study design: In this prospective cohort study, 90 consecutive preterm newb orns (<32 weeks' gestational age) had AABR hearing screening weekly from bi rth until a bilateral pass result was obtained. If the newborn had a unilat eral pass result, AABR screening was repeated in the same week. Data were a nalyzed by using the Kaplan-Meier survival function technique, resulting in a cumulative pass rate curve for postmenstrual age. Cox's regression metho d was used to analyze the effect of co-variables, such as sex and growth re striction, on pass rates. Results: Median gestational age was 29.5 weeks (range, 25.3-31.9 weeks), an d median birth weight was 1115 g (range, 600-1960 g). Mean age was 6.2 days (SD 4.3) at first test, 15.7 (SD 8.1) at second test, and 21.4 (SD 8.6) at third test. Eighty percent (CI: 70.2%-89.8%) of the newborns passed at 30. 3 weeks' postmenstrual age, 90% (CI: 83.6%-96.4%) passed at 31.2 weeks, and 100% passed at 34 weeks' postmenstrual age. The attainment of these pass r ates correlated to postmenstrual age was not significantly influenced by se x, growth restriction, or gestational age at birth. Postnatal pass rates (i n days) were strongly influenced by gestational age. Conclusion: AABR pass rates of >80% can be obtained from 30 weeks' postmens trual age. Therefore AABR neonatal hearing screening can be used before dis charge from a neonatal intensive care unit.