Indian Journal of Neonatal Medicine & Research

Current Insights into Newborn Hearing Screening: A Prospective Observational Study from a Tertiary Care Hospital in Northern India

Prakash Chandra Joshi, Bindiya Verma, Niranjan Kumar Singh, Sachin Verma

Introduction: Hearing impairment is one of the most common congenital disorders and can significantly affect speech, language, and cognitive development if not identified early. Universal newborn hearing screening plays a vital role in early diagnosis and intervention. However, data on neonatal hearing loss from developing countries, including India, remain limited. Aim: To determine the prevalence of screen positive hearing impairment among neonates attending a tertiary care hospital using Automated Auditory Brainstem Response (AABR) and its association with demographic variables and risk indicators. Materials and Methods: This prospective observational study was conducted at a tertiary care hospital in Northern India from September 2023 to August 2025. A total of 404 neonates were screened using a two-stage AABR protocol. Neonates who failed or had an aborted first-stage AABR underwent second-stage AABR screening. Those who failed the second stage were referred for diagnostic Brainstem Evoked Response Audiometry (BERA) at three months of age. Chi-square test was used to determine the association between different factors and outcomes. Results: Of the 404 neonates screened, AABR testing was aborted in 2 (0.5%), 62 (15.35%) failed, and 340 (84.15%) passed the first-stage screening. Of the 64 neonates who failed or had aborted tests, 37 underwent second-stage screening. Only 3 (8.11%) passed the second- stage AABR, while 34 (91.89%) failed. Overall, hearing impairment was detected in 34 neonates by two-stage screening, giving a prevalence of 8.42%, while the prevalence of confirmed hearing impairment was 0.74% (3/404). The association between neonatal morbidity and hearing abnormalities was highly significant (p-value <0.001). Conclusion: The prevalence of screen positive hearing impairment observed in this study (8.42%) was higher than that reported in Western literature but comparable to that in recent Indian studies. Poor follow-up compliance remains a major challenge in implementing universal newborn hearing screening programs. Strengthening follow-up mechanisms and ensuring early intervention for screen-positive neonates are essential to reduce the burden of childhood hearing loss.

Early Onset Sepsis and its Relation with Maternal Vaginal Infection: A Prospective Observational Study

Introduction: The risk of Early Onset Sepsis (EOS) is higher in newborns born to mothers with vaginal infections. High Vaginal Swab (HVS) is a simple technique for identifying causative organisms and for early detection of newborns at risk of sepsis. This method helps us to detect the organism in the vaginal canal, and thus help in understanding the causative organism and early initiation of empiric antibiotics for EOS in newborn infant. Aim: To evaluate the role of HVS culture in detecting the maternal vaginal infection and its relationship with EOS in newborns. Materials and Methods: The present prospective observational study was conducted at Department of Paediatrics, Prashanthi Hospital a tertiary care hospital at Warangal, Telangana state of India, over a period of two years, extending from June 2022 to May 2024. The study included all mothers with term gestation having vaginal discharge, Prolonged Rupture of Membranes (PROM) and chorioamnionitis. A total of 112 cases were collected, from the mothers included age, parity, delivery method, PROM, presence of chorioamnionitis, and maternal fever. The neonatal birth weight, gender, A- Appearance (skin color), P- Pulse (heart rate), G- Grimace (reflex irritability), A- Activity (muscle tone) and R- Respiration (breathing effort)(APGAR) scores, need for resuscitation, respiratory distress, lethargy, feeding difficulty, and need for treatment along with lab parameters were collected. Chi-square test was applied to test the association between the maternal HVS status and early onset neonatal sepsis. A p-value of <0.05 was considered significant. Results: The mean age of mothers was 26±2.47 years. Among 112 patients with suspected infection, HVS culture was positive in 75 (66.9%) and was found to be culture negative in 37 (33.1%) of women. The newborns, who were born to mothers who’s HVS culture was positive, 64 (85.3%) of newborns had sepsis screen positive. The association between the maternal HVS positive culture and sepsis screen in newborn were statistically significant (p<0.001). Conclusion: The risk of developing EOS in newborns born to mother with vaginal infection is high. Hence, HVS is simple and easy technique to identify the causative organism and prevent the morbidity and mortality in both mother and newborns.