Purpose: Infants needing neonatal intensive care unit (NICU) intervention have protracted timelines for diagnosis after not passing their newborn hearing screening despite being at higher risk for congenital hearing loss. The primary aim of this study was to evaluate the outcomes of early hearing detection for infants with a history of NICU admission. The secondary aim was to determine if diagnostic audiology services within the NICU setting accelerated diagnosis and intervention.
Method: A retrospective chart review was completed for infants referred for diagnostic audiologic testing from 2018 to 2021 at a tertiary urban-setting children's hospital. After exclusion criteria were applied, 367 infants with NICU history were included in the analysis. Various factors were recorded from electronic medical records. Time to diagnosis was derived and compared across (a) NICU location, (b) insurance type, and (c) race/ethnicity.
Results: Analysis of infants with NICU history revealed that 70% of infants had a diagnosis by 3 months corrected age. The level of in-NICU audiologic care did not significantly impact corrected age at diagnosis; however, loss to follow-up (LTFU) rates were higher for NICUs that did not provide in-hospital diagnostic services (10.0%) when compared to the NICU setting with inpatient audiology services (6.8%). In-NICU testing occurred on average 5.7 weeks prior to discharge, expediting diagnosis of hearing status compared to having to wait for an outpatient evaluation after discharge.
Conclusions: Timely hearing detection is feasible in the medically complex NICU population. Inpatient audiology diagnostic testing may help reduce LTFU and facilitate early hearing detection and intervention.
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