The relationship between permanent hearing loss risk indicators and diagnostic audiology assessment results among infants referred on a newborn hearing screen

Mr Jonathan Hall2, Dr Peter Carew2, Ms Alison Jagger1, Dr Zeffie Poulakis1,2,3, Dr Melinda  Barker1,2

1Royal Children’s Hospital , Melbourne, Australia,

2University of Melbourne, Melbourne, Australia,

 3Murdoch Children’s Research Institute, Melbourne, Australia


Background: While the efficacy of universal newborn hearing screening (UNHS) in promoting early detection and intervention is established, there is an expectation that screening programs operate efficiently and cost-effectively. This investigation aimed to determine whether hearing loss risk indicator information collected through an established UNHS program could inform the audiological assessment of infants, promoting efficiency across the screening pathway.

Methods: The study population (n = 1356) comprised of Victorian infants born in 2016 -2017 who returned a positive newborn hearing screen result and completed diagnostic audiological testing.  The risk indicator profile and audiological outcomes of these infants were analysed using yield calculations, and chi-square and logistic regression analyses.

Results: Infants with any risk indicator reported (n = 274; 20.2% of cohort) had a higher proportion of the target condition hearing loss (moderate or greater degree permanent bilateral) than those without a reported risk indicator.  The most frequently recorded risk indicators within the cohort were ototoxic medication administration, congenital abnormality of the head or neck, close family history of congenital hearing impairment, and syndrome known to be related to hearing loss.  Less commonly reported were meningitis/encephalitis, ventilation longer than 5 days, severe jaundice and maternal infection during pregnancy.

Infants were more likely to be diagnosed with a target condition hearing loss if they were recorded as having maternal infection during pregnancy (odds ratios (OR) 11.6; 95% Confidence Interval (CI) 2.6-51.5), close family history of permanent hearing loss (OR 6.4; 95% CI 3.7-11.0), or ototoxic medication administration (OR 1.8; 95% CI 1.0-3.1).

Implications: Risk indicator information routinely collected at the time of newborn hearing screening can promote efficiency of the screening pathway by flagging at the time of diagnostic audiology scheduling those infants most likely to have a diagnosis of a permanent hearing loss that requires intervention.


Jonathan Hall completed his Master of Clinical Audiology in 2018, and has recently commenced practice as audiologist in Queensland. His research was conducted in conjunction with the Victorian Infant Hearing Screening Program.