RESULTS AND ANALYSIS

A total of 150 neonates were included into the study during the study period, of which
37(24.66%) had refer in first screening 18 (12%) with hearing impairment in second screening.
Risk factors for hearing impairment as per ‗HRR‘ of as JCIH 2007 (―at risk group‖), as shown
in Table 3, Graph- 1, Flow Chart 2
Table 3: Distribution of Neonates with Risk factors

Risk factor NO. %

Jaundice requiring phototherapy 38 25.4
HIE of any degree 38 25.4
Receiving intensive or high dependency care 22 14.6
Birth weight less than 1500gms 16 10.6
Prematurity less than 32 weeks 15 10
Treatment with oto-toxic drugs 9 6
Meningitis 6 4
Suspected intra uterine infections 6 4
Total 150 100
Graph 1 : Distribution of risk factors among at risk infants

Meningitis
4% Suspected intra uterine infections
Treatment with 4%
oto-toxic drugs Jaundice requir-
6% ing phototherapy
25%
Prematurity less
than 32 weeks
10%

HIE of any degree

Birth weight less 25%
than 1500gms
11%

Receiving in-
tensive or high
dependency
care
15%
 Table 4: Characteristics of 150 neonates with risk factors

Characteristic Category No. %

Gender Male 78 52
Female 72 48
Birth Weight (Kg < 1.5 38 25.33
1.5 - 2.5 67 44.66
≥ 2.5 45 30
POG (Wks 26-32 32 21.33
33-36 56 37.33
37-42 62 41.33
Birth Primi 78 52
Order Multi 72 48

The characteristic of the gender distribution out of 150 neonates 52% (78) male were male and
48% (72) were female. It was seen that of 150 neonates screened, 38 infants had birth weight of
<1.5 kg, 67 neonates between 1.5-2.5 kg and 45 neonates >2.5. Out of 150 neonates, 32 neonates
were of gestation between 26-32 wks, 56 neonates between 33- 36 weeks, 62 neonates were
between 37–42 weeks of gestation, 78 (52%) neonates were born to primigravida mother and 72
(48%) neonates were born to multi gravida mothers.
 Table – 5 : Gender distribution and OAE screening

Gender Affected Pass

No. % No. %

Male 10 12.8 68 87.2

Female 8 11.1 64 88.9

Total 18 12 132 88

Graph 2 : gender distribution and OAE screen

100

87.2 88.9
90

80

70

60

50 Pass
Refer
40

30

20
12.8 11.1
10

0
Male Female

OAE screen conducted in 150 risk newborn, out of which 78 were males and 10 (12.8%) had
hearing impairment, and out of 72 females 8 (11.1% ) were with hearing impairment with
X2 = 0.1036 & p value = 0.7 with no significance
 Table 6 : Birth weight and OAE Screening

Birth Weight Affected Pass

(Kg)
No. % No. %
< 1.5 6 15.8 32 84.2
1.5 - 2.5 8 11.9 59 88.1
≥ 2.5 4 8.9 41 91.9
Total 18 12 132 88

100
91.9
90 88.1
84.2 %
80

70

60

50 Pass
40 Refer

30

20 15.8
11.9
8.9
10

0
< 1.5 1.5 - 2..0 ≥ 2.5

X2 = 0.9294 p value 0.62

Out of 150 high-risk new born screened it was found that, total of 38 were less than 1.5 kg,
among them 6 (15.8%) of them with hearing impairment, 1.5-2.5 Kg total of 67 there were 8
(11.9%) were with hearing impairment and remaining 45 more than 2.5 kg 4 (8.9%) were
affected withhearing impairment with p value = 0.62 with no significance
 Table 7 : Gestation with OAE screen

POG (Wks) Affected Pass

No. % No. %
26-32 5 15.6 27 84.4
33-36 8 14.2 48 85.8
37-42 5 8 57 92
Total 18 12 132 88

Graph 4 : Gestation with OAE screen

100
92
90 84.4 85.8

80

70

60

50 Pass
Refer
40

30

20 15.6 14.2
10 8

0
26-32 33-36 37-42

X2 =1.5 , p value 0.45

Among 150 screened it was found that new borns with risk factors between gestational age of
26-32 weeks were total of 32, 5 (15.6%) were with hearing impairment, and 33-36 weeks
gestational total of 56, 8 (14.2%) were with hearing impairment, between 37-42 weeks 62 were
screened 5 (8%) were with hearing impairment with p value = 0.45 with no significance
 Table 8 : Result Of Screening Protocol

Total Refer In first Refer In 2nd Incidence

Number Screening Screening (Refer Of Hearing
Screened (Refer Rate) Rate) screening
Total 150 37(24.66%) 18(12%) 18(12%)
screened

Graph 5 : Over All Incidence of OAE

Overall Incidence of Screening

Refer
12%

Pass OAE
Screening
88%

Among 150 high-risks new born screened the incidence of hearing impairment by oto-aucostic
emission screening is 12 % (18/150)
 Table Result of the 1st TEST

Outcome Frequency %
B/L pass 113 75.33
B/L Refer 28 18.66
R-Pass,L-Refer 9 6
Total 150 100

1st Test
120 113

100

80
1st Test
60

40
28
20
9

0
B/L pass B/L Refer R-Pass,L-Refer

In the first screening out of 150 of high-risk screened, 37 failed the initial OAE screening,
accounting to a referral rate of 24.66% and pass rate of 75.34%. Of the 37 who failed, 28
(18.6%) had bilateral refer, 9(6%) had right side pass and left side refer . (Flow chart 2).
 10: Result of the 2nd TEST

Outcome No. %
B/L Pass 19 12.7
B/L Refer 15 10
R-Pass,L-Refer 03 2.O
NA 113 75.3
Total 150 100

80
2nd Test
75.3

70

60

50

40

30

20
12.7
10
10
2
0
B/L Pass B/L Refer R-Pass,L-Refer NA

In the 2ND screening out of 37 neonates who failed the OAE for the 1ST screening of which 28
(18.6%) belonged to -bilateral refer and remaining 9 (6%) belonged to- right side pass and left
side refer. All these neonates were subjected to OAE screening for 2nd time 19 (12.7%) got pass,
15(10%) came out as bilateral refer and 3 (2.% ) were right side pass and left side refer (Flow
Chart
The referral rate in second screening was 12% in the total study cohort. (Table , table) (Graph
and )The 18 (12%) cases were further referred to confirm hearing deficit, using BERA and
further evaluation by the audiologist
 Incidence of Hearing Impaired

newborns Screened Incidence in the Incidence

cohort expressed%
150 18/150 12

Incidence hearing impaired in the total study cohort- 18 newborns among the study cohort of
150 screened, had hearing screening found to be refer and were subjected for further audiological
examination for hearing impairment by BERA. The overall incidence of hearing impairment is
12% 18/150 screened. (Table and Graph ) .
Incidence of hearing impairment in at risk newborns- Among 150 infants with risk factors
screened, around 18 had hearing impairment, showing an incidence of 12% in the risk newborns
(Table and Graph ), by two staged TEOAE . The distribution of ‗at risk‘ infants screened as per
risk their risk factors is shown in Table 12 and Graph 8. And the incidence of hearing
impairment in various groups of infants with risk factors is shown in Table 12.
 Distribution of Risk factors among at risk infants and the OAE
screening outcome

Risk factor Refer Pass

NO. % NO. %
Prematurity less than 32 weeks 3 20 12 80
Meningitis 1 16.6 5 83.4
Receiving intensive or high dependency care 3 13.6 19 86.4
HIE of any degree 5 13.1 33 86.9
Birth weight less than 1500gms 2 12.5 14 87.5
Jaundice requiring phototherapy 4 10.5 34 89.5
Suspected intra uterine infections 0 0 6 100
Treatment with Oto-toxic drugs 0 0 9 100
TOTAL 18 12 132 88
Graph 8 - Distribution of risk factors among at risk infants and the OAE
screening out come

120
100 100
100 89.5
83.4 86.4 86.9 87.5
80
80

60

40
20 16.6
20 13.6 13.1 12.5 10.5
0 0 Refer
0
Pass
s s re ee s py s gs
ek iti ca gr gm ra on ru
we ing cy de 0 0 e cti d
32 en en 15 th fe ic
n M d any n o to e in tox
n -
ha e of ha h rin o
sst d ep IE sst ngp te Ot
le H le ir i u ith
ity gh ht qu tra
r r hi ig e in n tw
u r
at ve
o we ice cte
d
tm
e
em si r th d e ea
Pr en Bi un sp Tr
int Ja Su
ng
eivi
c
Re
In this study total of 150 high-risk infants were evaluated, 18 infants were detected to have OAE
refer results. Among the risk factors, prematurity less than 32 weeks was found to have highest
percentage of affliction for hearing impairment. Out of total 15 cases, 3 cases found to have OAE
refer result which contributed to 20% of the total refer result among 18 refer cases. In the infants
with meningitis, out of a total of 6 cases, 5 cases found to have normal hearing screening and 1
cases found to have OAE refer result which contributed to second highest of the OAE refer cases
that is 16.6%. Among infants with Receiving intensive or high dependency care a total of 22
cases, 19 cases had pass result and 3 cases had refer result and contributed to 13.6 % of total
refer result which was found to be the third highest in the refer result. The other risk factors like
HIE of any degree out of 38 cases in 33 cases OAE results were found to be pass and 5 case the
result was refer and its 13.1 % of the total refer result. Among the risk factor babies Birth weight
less than 1500gms, out of 16 cases, 14 cases, found to be pass and 2 (12.5%) cases had hearing
impairment. Among other risk factors, jaundice requiring photo therapy and exchange , out of 38
cases 34 cases OAE result were found to be pass and 4 (10.5) cases had hearing impairment.
Among other risk factors suspected intra uterine infections, and newborn on oto toxic, none of
the babies had refer .table 12, Graph
 Table 13 Number of risk factors and OAE out come depicted in number and
percentage

OAE RESULT
No.of No.of
Risk cases Pass Refer
factors
NO % NO %

1 98 88 89.8 10 10.2

2 44 38 86.4 6 13.6

3 8 6 75 2 25

88 18 12
TOTAL 150 132

Graph 9 : Number of risk factors and OAE out come depicted in number and
percentage

89.8
86.4
90
% OF CASES

75
80

70

60

50
Pass
40 Refer
25
30
13.6
20 10.2

10

0
1 NO. OF RISK
2 FACTORS 3
Out of 150 high-risk infants 8 had >3 risk factors . among them 2 (25.0%) had hearing
impairment .44 infants had 2 risk factors out of which 6 (13.6%) had hearing impairment
indicating as the number of risk factors increase the chances of hearing impairment increase