AUTHOR=Sheng Haibin , Zhou Qian , Wang Qixuan , Yu Yun , Liu Lihua , Liang Meie , Zhou Xueyan , Wu Hao , Tang Xiangrong , Huang Zhiwu 

TITLE=Comparison of Two-Step Transient Evoked Otoacoustic Emissions and One-Step Automated Auditory Brainstem Response for Universal Newborn Hearing Screening Programs in Remote Areas of China

JOURNAL=Frontiers in Pediatrics

VOLUME=9

YEAR=2021

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2021.655625

DOI=10.3389/fped.2021.655625

ISSN=2296-2360

ABSTRACT=<p><bold>Objective:</bold> To compare the hearing screening results of two-step transient evoked otoacoustic emissions (TEOAE) and one-step automatic auditory brainstem response (AABR) in non-risk newborns, and to explore a more suitable hearing screening protocol for infants discharged within 48 h after birth in remote areas of China.</p><p><bold>Methods:</bold> To analyze the age effect on pass rate for hearing screening, 2005 newborns were divided into three groups according to screening time after birth: &lt;24, 24–48, and 48–72 h. All subjects received TEOAE + AABR test as first hearing screen, and those who failed in any test were rescreened with TEOAE + AABR at 6 weeks after birth. The first screening results of AABR and TEOAE were compared among the three groups. The results of two-step TEOAE screening and one-step AABR screening were compared for newborns who were discharged within 48 h. The time spent on screening was recorded for TEOAE and AABR.</p><p><bold>Results:</bold> The pass rate of TEOAE and AABR increased significantly with the increase of first screening time (<italic>P</italic> &lt; 0.05), and the false positive rate decreased significantly with the increase of first screening time (<italic>P</italic> &lt; 0.05). The failure rate of first screening of AABR within 48 h was 7.31%, which was significantly lower than that of TEOAE (9.93%) (<italic>P</italic> &lt; 0.05). The average time spent on AABR was 12.51 ± 6.36 min, which was significantly higher than that of TEOAE (4.05 ± 1.56 min, <italic>P</italic> &lt; 0.05). The failure rate of TEOAE two-step screening was 1.59%, which was significantly lower than one-step AABR.</p><p><bold>Conclusions:</bold> Compared with TEOAE, AABR screening within 48 h after birth can reduce the failure rate and false positive rate of first screening. However, compared with TEOAE two-step screening, one-step AABR screening has higher referral rate for audiological diagnosis. In remote areas of China, especially in hospitals with high delivery rate, one-step AABR screening is not feasible, and two-step TEOAE screening protocol is still applicable to UNHS screening as more and more infants discharged within 48 h after birth.</p>