Abstract
Background
Despite the high burden of global childhood hearing loss, compliance with universal newborn hearing screening (UNHS) guidelines is low in many low- and middle-income countries, including Kenya. Preterm infants are especially prone to an increased risk of hearing loss due to the associated perinatal and neonatal morbidities. The objectives of this study were to investigate the prevalence and risk factors of failed hearing screening in preterm newborns.
Methods
We conducted a hospital-based prospective cohort study of preterm infants at the Kenyatta National Hospital (KNH) and the Mbagathi County Referral Hospital newborn units (NBUs) in Nairobi, Kenya. Those born at ≤34 weeks’ gestational age were recruited and underwent Automated Auditory Brainstem Response (AABR) screening before their discharge. Infant characteristics, maternal demographics, pregnancy complications and neonatal illnesses were documented. Logistic regression was used to assess associations between risk factors and failed hearing screening.
Results
Screening was done on 376 infants. The average gestational age was 30.8 weeks and more than half were female (54.5%). Among these, 27 infants were referred (failed hearing screening either in one or both ears), a prevalence of 7.2%. There was no significant correlation with any maternal characteristics like age, attendance of antenatal care and pregnancy complications. However, after multivariable adjustment, clarithromycin remained independently associated (p=0.01) while asphyxia had a borderline association (p=0.05).
Conclusion
We report a prevalence of failed newborn hearing screening by AABR of 7.2% among preterm infants, substantially higher than the global baseline estimates for the general newborn population. Clarithromycin and birth asphyxia were the only factors associated with a failed hearing screening. These findings underscore the importance of implementing and strengthening UNHS programmes in Kenya and sub-Saharan Africa, with targeted follow-up of preterm and high-risk infants to enable early detection and intervention.