The Effects of Mode of Delivery on Neonatal Screening Evaluated by Automated Auditory Brainstem Response

Authors : Nura Fitnat Topbaş Selçuki, Zübeyde Aytufan, Cihan Kaya, Elif Ganime Aygün, K. Doğa Seçkin, Pınar Kadiroğullari

Pages : 371-376

Doi:10.31067/acusaglik.1246263

View : 55 | Download : 42

Publication Date : 2023-07-10

Article Type : Research Article

Abstract :Background/Purpose: Neonatal hearing screening results are affected by several perinatal and neonatal factors. It is known that false positivity (FP) in the failure of newborn hearing screening increases parental concern and anxiety and has a negative impact on healthcare costs. There are conflicting reports on the effect of the mode of delivery on hearing screening results. This study aimed to investigate the role of mode of delivery on neonatal hearing by comparing the automated auditory brainstem (ABR) results of newborns born with vaginal delivery (VD) or cesarean section (CS) and to identify perinatal and neonatal factors associated with failure of the first neonatal hearing screening test results. Methods: This retrospective case-control study was conducted at our obstetrics clinic between December 2018 and June 2019. Following the exclusion of newborns with incomplete data, with congenital and chromosomal anomalies, with CMV infection, with anatomical deformities involving the face and the ears, and who received their hearing screening <12 hours postpartum and also the exclusion of pregnancies with maternal infections, recurrent pregnancy loss, maternal smoking, and alcohol abuse, a total of 300 newborns, 176 of which were born with VD and 124 were born with CS were included in this study. The neonatal hearing screening was performed with automated ABR. Results: A total of 181 newborns (60.3%) did not have hearing loss whereas in 39.7% hearing loss was detected. When the VD and the CS groups were compared, the mean gravidity and parity were reported to be similar. However, the mean weeks of gestation at birth (p=0.02), 1 min. Apgar score (p=0.007) and 5 min. Apgar score (p=0.005) were significantly lower in the CS group. A 57.4% hearing loss was reported in the VD group and a 64.5% hearing loss was detected in the CS group. The difference between the groups was not significant (p=0.13). The groups were also statistically similar in terms of family history of hearing loss, NICU stay, maternal morbidity and pregnancy complications, p values being 0.58, 0.09, and 0.14, respectively. Conclusion: National Hearing Screening Programs are essential in detecting a hearing failure in newborns in time for a prompt diagnosis and appropriate management of the newborns. However, it is also essential to understand which factors affect newborn hearing and also it is important to minimize FP rates to report accurate results. Our results indicate that mode of delivery does not significantly affect newborn hearing. However, further studies are needed to address the conflicting results in the literature.
Keywords : Neonatal Hearing, Mode of Delivery, Auditory Brainstem Response, Cesarean Section, Vaginal Delivery