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Background <p>Early detection of neonatal hearing loss is essential to prevent speech and developmental delays. The timing of testing can affect accuracy and false-positive rates, with limited data available from Pakistan.</p> Aims <p>This study aimed to evaluate the optimal postnatal timing for neonatal hearing screening via TEOAE in Karachi, Pakistan.</p> Materials and methods <p>This cross-sectional study (January 2020–December 2024) included 5,143 neonates screened with TEOAE at two hospitals in Karachi. Both healthy newborns and NICU admissions were enrolled, excluding those with congenital ear malformations or incomplete records. Screening was performed on Day 3, 7, or 21; abnormal results were retested. Data were analyzed in SPSS v26.0 using Chi-square and Fisher’s exact tests (<i>p</i> &lt; 0.05).</p> Results <p>Of 5,143 neonates screened, 4,915 (95.6%) passed, 206 (4.0%) required retesting, and 26 (0.5%) for confirmatory BERA. Day 7 yielded the highest diagnostic accuracy, with 1,675 of 1,714 (97.7%) passing and only 39 (2.3%) abnormal results, compared to 1,555 of 1,715 (90.7%) passing on Day 3 and 1,615 of 1,714 (94.2%) passing on Day 21. The differences were statistically significant (χ<sup>2</sup> = 76.5, <i>p</i> &lt; 0.001). Year-wise analysis also demonstrated progressive improvement in pass rates and reduction in referrals across the study period.</p> Conclusion <p>Screening at Day 7 postnatally provides the optimal balance of sensitivity and specificity for neonatal hearing screening via TEOAE. These findings support tailoring universal newborn hearing screening programs in Pakistan to conduct testing on the seventh day of life, reducing false positives and ensuring timely identification of true cases.</p>

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Evaluation of optimal postnatal timing for the screening of neonatal hearing via transient evoked oto-acoustic emission (TEOAE): a retrospective cross-sectional study

  • 期刊论文

  • 发表日期：

    2025年12月23日

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  • Shanila Feroz,
  • Malaika Irshad,
  • Sheas Ahmed Shamsi,
  • Eesha Sohail,
  • Ahmed Hamid,
  • Muhammad Rohan

摘要

Background

Early detection of neonatal hearing loss is essential to prevent speech and developmental delays. The timing of testing can affect accuracy and false-positive rates, with limited data available from Pakistan.

Aims

This study aimed to evaluate the optimal postnatal timing for neonatal hearing screening via TEOAE in Karachi, Pakistan.

Materials and methods

This cross-sectional study (January 2020–December 2024) included 5,143 neonates screened with TEOAE at two hospitals in Karachi. Both healthy newborns and NICU admissions were enrolled, excluding those with congenital ear malformations or incomplete records. Screening was performed on Day 3, 7, or 21; abnormal results were retested. Data were analyzed in SPSS v26.0 using Chi-square and Fisher’s exact tests (p < 0.05).

Results

Of 5,143 neonates screened, 4,915 (95.6%) passed, 206 (4.0%) required retesting, and 26 (0.5%) for confirmatory BERA. Day 7 yielded the highest diagnostic accuracy, with 1,675 of 1,714 (97.7%) passing and only 39 (2.3%) abnormal results, compared to 1,555 of 1,715 (90.7%) passing on Day 3 and 1,615 of 1,714 (94.2%) passing on Day 21. The differences were statistically significant (χ2 = 76.5, p < 0.001). Year-wise analysis also demonstrated progressive improvement in pass rates and reduction in referrals across the study period.

Conclusion

Screening at Day 7 postnatally provides the optimal balance of sensitivity and specificity for neonatal hearing screening via TEOAE. These findings support tailoring universal newborn hearing screening programs in Pakistan to conduct testing on the seventh day of life, reducing false positives and ensuring timely identification of true cases.