Hearing assessment in high-risk neonates by brain stem evoked auditory response (BERA) at a teaching hospital in rural Telangana

Abstract

Introduction: Severe pre-lingual hearing impairment has important consequences for language acquisition, communication, and cognitive, social and emotional development. Indeed evidence is increasing that even moderate hearing loss in very young children can be detrimental. Brainstem evoked response audiometry (BERA), when used and interpreted properly, provide a powerful method of obtaining reliable estimates of auditory sensitivity in infants, young children, and other individuals who cannot or will not provide reliable results on behavioral hearing tests.

Materials & Methods: In this study 110 high risk neonates having one or more risk factors, according to the criteria stated by American Academy of Pediatrics, JCIH 2007 were selected from Newborn unit, of MIMS, Ghanpur. The high risk neonates were subjected to BERA testing in a sound proof room in our study, 30 dB is taken as cutoff for normal auditory threshold.

Results: Mean birth weight of neonates studied was 2.60±0.67 kg. Mean age of neonates at which first BERA done is 19.32±11.3 days. Hyperbilirubinemia requiring Exchange transfusion and TORCH infection were identified as significant risk factors with p-values 0.028 and 0.011 respectively.

Conclusion: Hearing impairment is common in high risk NICU graduates. Bilateral hearing impairment is more common than unilateral. All high risk infants must be screened for hearing impairment prior to discharge and retesting of infants with abnormal BERA after 3 months and subsequently if necessary. Newborn screening is mandatory to identify hearing loss in the prelinguistic period to reduce the burden of handicap in the community