Universal Screening of Newborns from a Tertiary Care Hospital in South India: A Prospective Analytical Study

Ngohlaki, K.; Raja, Kalaiarasi; Kushwaha, Akshat; Lalthanthuami, H.T.; Penubarthi, Lokesh Kumar; Saxena, Sunil Kumar; Alexander, Arun; Ganesan, Sivaraman

doi:10.1055/s-0045-1809928

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Original Research • Int Arch Otorhinolaryngol. 30 (1) • 2026 • https://doi.org/10.1055/s-0045-1809928 linkcopy

Universal Screening of Newborns from a Tertiary Care Hospital in South India: A Prospective Analytical Study

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective To estimate the prevalence of hearing impairment and significant risk factors for congenital loss in a tertiary hospital in South India.

Methods Over 3 years, a prospective analytical study was conducted in the Department of Otorhinolaryngology in a tertiary hospital in South India. All newborns born in the hospital or those referred were initially screened using the Transient Evoked Otoacoustic Emissions (TEOAE) in a soundproof room by a trained audiologist at 24 to 48 hours of birth. Results were either "PASS" or "REFER." Those who did not pass the initial screening were retested with TEOAE at their 6-week vaccination appointment. If the second result was "REFER," the neonate underwent Brain Evoked Response Auditory (BERA) for confirmation.

Results A total of 3,679 neonates (1,931 males, 1,748 females) underwent TEOAE testing. Of those, 2,426 (65.9%) passed the first test, and 1,253 (34.1%) were referred. The second TEOAE test was done for 1,174 patients, with results of 1,013 (86.29%) as "PASS" and 161 (13.71%) as "REFER." The BERA results of 95 neonates showed normal in 84 (88.42%), and 11 (11.58%) had profound hearing loss. The prevalence of hearing impairment in the present study was 0.29% (95% CI: 0.2–0.6%). Major risk factors such as maternal infections, like toxoplasmosis, others (syphilis, hepatitis B), rubella, cytomegalovirus, and herpes simplex (TORCH), craniofacial anomalies, low birth weight < 1,500 g, low Appearance, Pulse, Grimace, Activity and Respiration (APGAR) scores (0–4 at 1 minute and 0–6 at 5 minutes), and mechanical ventilation lasting for 5 days or longer, were significantly associated with hearing impairment at p < 0.05.

Conclusion Newborn hearing screenings must be made mandatory, irrespective of risk factors. This way, early diagnosis and necessary interventions can be implemented.

Keywords
congenital; hearing loss; newborn infant screenings; brainstem auditory evoked potential; audiologic rehabilitation

S. No.	Major risk factors		Hearing status		p-value
S. No.	Major risk factors		Impaired n (%)	Normal n (%)	p-value
1	Family history of hearing lossa	Present	0	18 (100)	0.816
1	Family history of hearing lossa	Absent	11 (0.3)	3,650 (99.7)	0.816
2	Maternal infections like TORCHa	Present	1 (6.3)	15 (93.8)	< 0.001
2	Maternal infections like TORCHa	Absent	10 (0.3)	3,653 (99.7)	< 0.001
3	Craniofacial anomaliesa	Present	3 (5.9)	48 (94.1)	< 0.001
3	Craniofacial anomaliesa	Absent	8 (0.2)	3,620 (99.8)	< 0.001
4	Birth weight < 1,500 ga	Present	6 (0.8)	709 (99.2)	0.003
4	Birth weight < 1,500 ga	Absent	5 (0.2)	2,959 (99.8)	0.003
5	Bilirubin > 20 mg/dla	Present	0	165 (100)	0.472
5	Bilirubin > 20 mg/dla	Absent	11 (0.3)	3,503 (99.7)	0.472
6	APGAR scores (0–4 at 1 min; or 0–6 at 5 min)a	Present	6 (0.7)	890 (99.3)	0.019
6	APGAR scores (0–4 at 1 min; or 0–6 at 5 min)a	Absent	5 (0.2)	2,778 (99.8)	0.019
7	Mechanical ventilation ≥5 daysb	Present	1 (25.0)	3 (75.0)	0.012
7	Mechanical ventilation ≥5 daysb	Absent	10 (0.3)	3,665 (99.7)	0.012
8	Preterm deliveryb	Present	0	1 (100)	0.956
8	Preterm deliveryb	Absent	11 (0.3)	3,667 (99.7)	0.956

S. Number	Major risk factors		Hearing status		AOR (95%CI)	p-value
S. Number	Major risk factors		Impaired n (%)	Normal n (%)	AOR (95%CI)	p-value
1	Maternal infections like TORCHa	Present	1 (6.3)	15 (93.8)	43.75 (4.67–409.39)	0.001
1	Maternal infections like TORCHa	Absent	10 (0.3)	3,653 (99.7)	Ref
2	Craniofacial anomaliesa	Present	3 (5.9)	48 (94.1)	53.92 (11.96–243.12)	< 0.001
2	Craniofacial anomaliesa	Absent	8 (0.2)	3,620 (99.8)	ref
3	Birth weight < 1,500 ga	Present	6 (0.8)	709 (99.2)	4.34 (1.09–17.26)	0.037
3	Birth weight < 1,500 ga	Absent	5 (0.2)	2,959 (99.8)	ref
4	APGAR (0–4 at 1 min; 0–6 at 5 min)a	Present	6 (0.7)	890 (99.3)	2.43 (0.66–8.99)	0.184
4	APGAR (0–4 at 1 min; 0–6 at 5 min)a	Absent	5 (0.2)	2,778 (99.8)	ref
5	Mechanical ventilation ≥5 daysb	Present	1 (25.0)	3 (75.0)	114.23 (8.72–1,496.99)	< 0.001
5	Mechanical ventilation ≥5 daysb	Absent	10 (0.3)	3,665 (99.7)	ref

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[TFN1] Abbreviations: %, percentage; APGAR, appearance, pulse, grimace, activity, respiration; n, number of participants; TORCH, toxoplasmosis, rubella, cytomegalovirus, herpes simplex.

[TFN2] Notes:

[TFN3] ^a
Chi-square test.

[TFN4] ^b
Fisher's exact test; p < 0.05.