Results of a 10-year hearing screening using automated auditory brainstem response in newborns: The two-step AABR method

Objectives: Approximately 1-6 in every 1000 children are born with hearing loss. An automated auditory brainstem response (AABR) test is essential for screening newborns for abnormal hearing. At the tertiary hospital, we have been using a two-step AABR protocol for newborn hearing assessment since 2005. This study aimed to report the 10-year hearing screening results of newborns at the institution, and prove the efficacy of the two-step AABR protocol. Methods: From August 2005 to January 2015, 3059 newborns were screened through AABR testing using the MASTER ABaer system. The first screening test was performed after the first 24 h of life. If a newborn was referred, the test was performed within 1 month after discharge from the hospital. The results were regarded as pass when the point optimized variance ratio was >3.5, using a stimulus level of 35 dB HL. When newborns were referred for the second AABR, they received follow-up tests including tympanometry, ABR, auditory steady-state response, and otoacoustic emission within 3 months. Results: A total of 3059 newborns underwent newborn hearing screening tests over a period of 10 years. One hundred and twenty (3.9%) newborns were referred with the initial AABR, and 104 (3.4%) were referred with a subsequent AABR. Of the newborns, 42 (1.37%) were confirmed to have a bilateral hearing impairment. Conclusions: It is known that the referral rate for the AABR test is 3-4%, as recommended by the Joint Committee on Infant Hearing. Our data showed a referral rate of 3.4%. The two-step AABR test has been useful for screening hearing loss in newborns at tertiary hospital.