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Abstract
Aim: To establish the incidence and predictors of sensorineural hearing loss (SNHL) in infants with neonatal jaundice (NNJ) in an inner-city setting with predominantly non-hospital births.
Methods: A community-based study in Lagos, Nigeria in which infants with SNHL attending well-child clinics for routine immunisation were detected by two-stage universal hearing screening with transient evoked oto-acoustic emissions and automated auditory brainstem response from July 2005 to December 2006. Predictors of SNHL among infants with a history of NNJ were determined with multivariate logistic regression based on adjusted odds ratio (OR) at 95% confidence intervals (CI).
Results: Of the 3676 infants enrolled, 52.4% were not born in hospital and 71 (2.1%) were confirmed to have SNHL. Fourteen (6.0%) of the 234 infants with NNJ had SNHL. Bilateral hearing loss was moderate (41–70 dB) in three (21.4%), severe (71–90 dB) in eight (57.1%) and profound (>90 dB) in two (14.3%) infants. One infant (7.1%) had unilateral SNHL. Six (42.9%) of the infants with SNHL had a profile suggestive of auditory neuropathy/dyssynchrony. Christianity (OR 0.15, CI 0.03–0.93), multiparity (OR 7.33, CI 1.17–45.99), low social class (OR 6.04, CI 1.33–27.48), infant's age (OR 10.17, CI 1.91–54.05), multiple gestations (OR 10.55, CI 1.98–56.11) and exchange blood transfusion (OR 7.74, CI 1.66–36.2) were predictive of SNHL. This model has a sensitivity of 85.7%, a specificity of 83.6%, a negative predictive value of 98.9% but a positive predictive value of only 25.0% for identifying SNHL among infants with severe NNJ.
Conclusions: SNHL is prevalent among infants with NNJ and community-orientated early detection to curtail the associated long-term developmental consequences is feasible in resource-poor settings where facilities for clinical monitoring are limited. Hearing evaluation of infants treated for severe NNJ should be incorporated into the management and follow-up of these patients.