Abstract:Objective To study the duration of automated auditory brainstem response (AABR) test for initial hearing screening and the factors influencing the duration in neonates. Methods A total of 472 neonates who were admitted to the neonatal intensive care unit (NICU) were enrolled as the study group and 182 healthy neonates were enrolled as the healthy control group. The influence of the duration of AABR test on the initial screening results was observed in the two groups. The influencing factors for the AABR test duration were analyzed. Results In the AABR screening of 180, 360, and 540 seconds, the study group had a failure rate of 41.5%, 28.4%, and 24.4% respectively, while the healthy control group had a failure rate of 31.3%, 19.8%, and 15.4% respectively, showing a decreasing trend with the extension of test time in both groups (P < 0.05). In the two groups, the screening results of 180-second testing were moderately consistent with those of 360- or 540-second testing (Kappa<0.75, P < 0.05), and the screening results of 360-second testing were highly consistent with those of 540-second testing (Kappa>0.75, P < 0.05). In the study group, the median duration of AABR test was 108 seconds (95%CI:97-120 seconds), which was significantly longer than the duration of 75 seconds (95%CI:65-85 seconds) in the healthy control group (P < 0.05). The Cox regression analysis showed that maternal age ≥ 35 years, anemia, and electrolyte disturbance (RR < 1, P < 0.05) were independent risk factors for prolonged AABR test duration, while the prolonged continuous positive airway pressure-assisted ventilation was a protective factor (RR > 1, P < 0.05). Conclusions The AABR test time of 360-540 seconds for initial hearing screening helps to reduce false positive results due to environmental and risk factors in neonates. It may be useful to reduce the false positive results of AABR screening before discharge by taking corresponding intervention measures for NICU neonates with high risk factors.
