Farladansky-Gershnabel Sivan, Kariv Liron, Schreiber Hanoch, Ravid Dorit, Cohen Gal, Biron-Shental Tal, Kovo Michal, Krivoshey Racheli Edelman, Arnon Shmuel
Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel.
Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv, Israel.
Eur Arch Otorhinolaryngol. 2025 Apr 30. doi: 10.1007/s00405-025-09428-3.
Otoacoustic emission (OAE) is a widely utilized method for screening newborns for congenital hearing loss. While OAE-based screening has high sensitivity, it is associated with high false-positive rates when conducted shortly after birth. Previous studies found that infants delivered by cesarean section show higher false-positive rates. Nonetheless, other modes of delivery have not been investigated to date. This study aims to evaluate the impact of maternal, neonatal, and perinatal factors on hearing screening false-positive results.
This retrospective study included 5,621 infants with normal hearing. Infants were divided into two groups: those who failed the initial OAE hearing screening were assigned to the study group, and those who passed were assigned to the control group. Maternal, neonatal, and perinatal factors were extracted from medical records and analyzed to assess possible associations with failing the initial OAE screening.
A total of 365 out of 5621 (6.5%) neonates failed the initial OAE hearing screening. The study group had a higher prevalence of infants delivered by elective or emergency cesarean section, as well as by vacuum-assisted delivery, compared to the control group. Multivariate analysis showed that the mode of delivery had a significant effect on false-positive results, with odds ratios of 15.5, 7.2, and 8.6 for infants born by elective cesarean section, emergency cesarean section, and vacuum delivery, respectively, compared to vaginal delivery.
Infants delivered by cesarean section or vacuum extraction have higher odds of failing the initial OAE screening when conducted within 48-72 h after birth. Further research is needed to determine the optimal timing for hearing screening.
耳声发射（OAE）是一种广泛用于筛查新生儿先天性听力损失的方法。虽然基于OAE的筛查具有较高的灵敏度，但在出生后不久进行时，其假阳性率较高。先前的研究发现，剖宫产分娩的婴儿假阳性率更高。然而，迄今为止尚未对其他分娩方式进行研究。本研究旨在评估母亲、新生儿和围产期因素对听力筛查假阳性结果的影响。
这项回顾性研究纳入了5621名听力正常的婴儿。婴儿被分为两组：初次OAE听力筛查未通过的婴儿被分配到研究组，通过筛查的婴儿被分配到对照组。从医疗记录中提取母亲、新生儿和围产期因素，并进行分析，以评估与初次OAE筛查未通过之间可能存在的关联。
5621名新生儿中共有365名（6.5%）初次OAE听力筛查未通过。与对照组相比，研究组中择期或急诊剖宫产以及真空辅助分娩的婴儿比例更高。多变量分析表明，分娩方式对假阳性结果有显著影响，与阴道分娩相比，择期剖宫产、急诊剖宫产和真空辅助分娩的婴儿假阳性结果的比值比分别为15.5、7.2和8.6。
剖宫产或真空吸引分娩的婴儿在出生后48 - 72小时内进行初次OAE筛查时未通过的几率更高。需要进一步研究以确定听力筛查的最佳时机。
