Evaluation of hearing impairment in neonatal intensive care unit (NICU) admitted newborns using otoacoustic emissions (OAE) and brainstem evoked response audiometry (BERA): A prospective observational study”
DOI:
https://doi.org/10.51168/sjhrafrica.v6i9.2020Keywords:
Neonatal hearing loss, Otoacoustic Emissions (OAE), Brainstem Evoked Response Audiometry (BERA), Neonatal Intensive Care Unit, Very Low Birth Weight (VLBW)Abstract
Background
Hearing impairment in neonates, particularly those admitted to Neonatal Intensive Care Units (NICUs), is a major cause of delayed speech, language, and cognitive development if not diagnosed and addressed early. The prevalence of hearing loss increases significantly among NICU-admitted infants due to risk factors such as prematurity, very low birth weight (VLBW), hyperbilirubinemia, sepsis, and ototoxic medication exposure.
Aim
To assess the incidence and risk factors of hearing impairment in NICU-admitted newborns using Otoacoustic Emissions (OAE) and Brainstem Evoked Response Audiometry (BERA).
Methods
This prospective observational study was conducted in the NICU of Hitech Medical College & Hospital, Bhubaneswar, from October 2022 to October 2024. One hundred NICU-admitted neonates underwent a three-stage auditory screening: OAE1 on Day 3, OAE2 at 6 weeks, and diagnostic BERA at 3 months. Demographic and clinical data were collected, including key risk factors.
Results
The incidence of REFER results was 16% on OAE1, 14% on OAE2, and 8% confirmed by BERA. A significant association was found between hearing loss and VLBW, hyperbilirubinemia ≥20 mg/dL, sepsis, mechanical ventilation, and ototoxic medication use. OAE2 showed strong concordance with BERA (p<0.001), supporting its reliability as a screening tool.
Conclusion
Sequential screening using OAE and BERA is effective in early detection of hearing impairment in NICU-admitted neonates. High-risk infants, particularly those with VLBW, sepsis, or hyperbilirubinemia, require prioritized auditory evaluation. Early diagnosis and intervention are essential to ensure optimal neurodevelopmental outcomes. Integrating structured hearing screening into NICU protocols is strongly recommended.
Recommendations
This study recommends routine OAE screening with confirmatory BERA for all NICU-admitted newborns, structured follow-up for high-risk infants, and integration of universal screening with counseling, staff training, and early rehabilitation into neonatal care.
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Copyright (c) 2025 Dr. Aparna Aradhana , Dr. Bighneswar Senapati , Dr. Suchismita Panda , Dr. Nitish Jena
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