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CC BY 4.0 · Am J Perinatol
DOI: 10.1055/a-2675-1768
Original Article

Timing of Newborn Hearing Screening Effects on Passing Rates: A Prospective Cohort Study

Wongsathon Seehiranwong
1   Department of Pediatrics, Faculty of Medicine, Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
,
Pichada Saengrat
1   Department of Pediatrics, Faculty of Medicine, Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
› Institutsangaben
Funding None.
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Abstract

Objectives

Newborn hearing screening using transient evoked otoacoustic emissions (TEOAEs) is essential for early detection of hearing impairment. The Joint Committee on Infant Hearing recommends screening near hospital discharge but does not specify an optimal timing. To determine the optimal timing for TEOAE screening in neonates at low risk of hearing impairment and to identify perinatal factors influencing pass rates.

Study Design

Neonates underwent sequential TEOAE screening based on postnatal age at the time of testing: less than 24, 24 to 36, 36 to 48, and more than 48 hours, with follow-up at 1 month for persistent failures. Statistical analyses included Fisher's exact test to compare pass rates across time intervals and multivariate Cox's proportional hazards regression and Laplace regression to assess factors associated with screening outcomes.

Results

Among 408 neonates, the median passing age was 23.8 hours (interquartile range: 14.3). Pass rates improved with later screening: 53.7% at less than 24 hours, 80.1% at 24 to 36 hours, 92.6% at 36 to 48 hours, and 99.3% at more than 48 hours. A significant improvement was observed only at more than 48 hours (odds ratio: 5.26; p = 0.0153). Cesarean delivery was associated with delayed passing compared with vaginal delivery (p = 0.036). Late preterm neonates demonstrated a significantly delayed passing time of approximately 12.9 hours (p < 0.01), whereas small for gestational age neonates passed earlier by 8.2 hours (p = 0.021).

Conclusion

Screening at greater than or equal to 48 hours significantly improved pass rates. An older age at successful screening was observed among preterm neonates and those delivered by cesarean section, underscoring the need for tailored follow-up protocols. These findings highlight the importance of optimizing screening strategies to enhance early detection and intervention.

Key Points

  • The ideal timing for newborn hearing screening remains unclear, affecting accuracy and follow-up rates.

  • Early TEOAE screening may lead to high false positives due to residual ear fluid, increasing unnecessary follow-ups.

  • Optimizing timing of the hearing screening window can enhance accuracy, reduce false positives, and improve clinical efficiency.

Keywords

newborn hearing screening - otoacoustic emission - screening timing - TEOAE


Publikationsverlauf

Eingereicht: 14. März 2025

Angenommen: 17. Juli 2025

Accepted Manuscript online:
04. August 2025

Artikel online veröffentlicht:
20. August 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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