Universal Newborn Hearing Screening using A-TEOAE and A-ABR: the experience of a large public hospital

BACKGROUND: Universal Newborn Hearing Screening (UNHS) aims to identify hearing loss in the early postnatal period; prompt detection of bilateral or unilateral hearing loss is mandatory for timely intervention. METHODS: This retrospective study reports the results of the first two years of a UNHS program on 4,719 newborns in a large public Italian hospital. Screening was divided into two levels: Automatic Transient Otoacoustic Emissions were used for first level; Automated Auditory Brainstem Response for second level. Second level included children with a REFER response at first level and babies with a family history for hearing loss or other risk factors. Hearing loss diagnosis was made using clinical Auditory Brainstem Response. RESULTS: During first level, 254 (5.4%) newborns were REFER. At retest, 130 (51.1%) babies were PASS and 48 (18.8%) were REFER. 76 babies dropped out (29.9%). 146 babies (3.1%) were referred to the second level: 48 for a REFER response at first level and 98 for a PASS response but potential hearing loss due to risk factors. 24 babies dropped out (16.4%). Out of 122 newborns tested in the second level, 105 (86.1%) had a PASS response and 17 (13.9%) were REFER. Our screening protocol identified 7 (0.14%) babies with profound hearing loss; 5 had unilateral and 2 had bilateral hearing loss. 2 babies dropped out at diagnostic level (11.8%). CONCLUSIONS: A correct and early diagnosis of hearing loss is mandatory to prevent permanent consequences; the spread of hearing screening programs is the optimal solution to reach this goal.