Neonatal Screening for Congenital Hearing Loss in the North of Jordan; Findings and  Implications

Amjad Nuseir, Maha Zaitoun, Hasan Albalas, Malak Douglas, Yazan Kanaan Kanaan, Ahmad AlOmari, Firas Alzoubi


Background: Congenital hearing loss is one of the important illnesses that affect newborns. Early diagnosis and treatment are a challenge for medical authorities in developing countries to improve children’s functional, intellectual, emotional, and social abilities. We aimed to study the prevalence of congenital hearing loss in northern Jordan community and identify factors that could affect hearing screening protocol. Methods: Prospective cross‑sectional study of 1595 infants born in our hospital underwent hearing screening tests. Totally, 104 were tested in NICU and the rest examined in the nursery room using Otoacoustic emission (OAE) test as a primary testing tool. The patients were followed in the three hearing screening phases. Factors affecting screening results were studied and analyzed. Results: The total number of newborns who didn’t pass the first OAE test in one or both ears were 90 (5.6%); 69 from the nursery group and 21 from the NICU group. In the 2nd screening phase 21 (23.3%) didn’t attend the appointment. Sixty‑four passed the second screening OAE test. Five newborns (5.6%) had a second refer result in one or both ears and referred for a diagnostic ABR test. Three infants passed the test and two found to have bilateral hearing loss. Conclusions: Hearing screening test is conducted via a 3‑phases‑protocol. OAE is used in the first two phases and ABR in the third phase. Hearing results is significantly affected for infants admitted to NICU. The following factors increase OAE fail response: mechanical ventilation for more than 5 days, Hyperbilirubinemia, associated congenital anomalies. Mode of delivery doesn’t have statistical significance on hearing screening results.


Deafness; hearing; hearing test; otoacoustic emission; screening

Full Text:



Erenberg S. Automated auditory brainstem response testing for

universal newborn hearing screening. Otolaryngol Clin North

Am 1999;32:999‑1007.

Mehl AL, Thomson V. Newborn hearing screening: The great

omission. Pediatrics 1998;101:E4.

Yoshinaga‑Itano C. Benefits of early intervention for children

with hearing loss. Otolaryngol Clin North Am 1999;32:1089‑102.

Nikolopoulos TP. Neonatal hearing screening: What we

have achieved and what needs to be improved. Int J Pediatr

Otorhinolaryngol 2015;79:635‑7.

Hess M, Finckh‑Kramer U, Bartsch M, Kewitz G, Versmold H,

Gross M. Hearing screening in at‑risk neonate cohort. Int J

Pediatr Otorhinolaryngol 1998;46:81‑9.

Wroblewska‑Seniuk K, Dabrowski P, Greczka G, Szabatowska K,

Glowacka A, Szyfter W, et al. Sensorineural and conductive

hearing loss in infants diagnosed in the program of universal newborn hearing screening. Int J Pediatr Otorhinolaryngol


Hone SW, Smith RJ. Genetics of hearing impairment. Semin

Neonatol 2001;6:531‑41.

Nance WE. The genetics of deafness. Ment Retard Dev Disabil

Res Rev 2003;9:109‑19.

Wroblewska‑Seniuk K, Greczka G, Dabrowski P, Szyfter W,

Mazela J. The results of newborn hearing screening by means

of transient otoacoustic emissions‑has anything changed

over 10 years? Int J Pediatr Otorhinolaryngol 2017;96:4‑10.

Yoshinaga‑Itano C. Early intervention after universal neonatal

hearing screening: Impact on outcomes. Ment Retard Dev

Disabil Res Rev 2003;9:252‑66.

Joint Committee on Infant Hearing; American Academy of

Audiology; American Academy of Pediatrics; American

Speech‑Language‑Hearing Association; Directors of Speech

and Hearing Programs in State Health and Welfare Agencies.

Year 2000 position statement: Principles and guidelines for

early hearing detection and intervention programs. Pediatrics


Grill E, Hessel F, Siebert U, Schnell‑inderst P, Kunze S,

Nickisch A, et al. Comparing the clinical effectiveness of

different newborn hearing screening strategies. A decision

analysis. BMC Public Health 2005;5:12.

Mezzano P, Serra G, Galevo MG, STERN Group. Cost analysis

of an Italian neonatal hearing screening programme. J Matern

Fetal Neonatal Med 2009;22:806‑11.

Zaitoun M, Nuseir A. Parents’ satisfaction with a trial of a

newborn hearing screening programme in Jordan. Int J Pediatr

Otorhinolaryngol 2020;130:109845.

Berg AO, Allan JD, Frame PS, Homer CJ, Johnson MS,

Klein JD, et al. Newborn hearing screening: Recommendations

and rationale. Am J Nurs 2002;102:83‑9.

Linssen AM, Joore MA, Theunissen EJ, Anteunis LJ. The effects

and costs of a hearing screening and rehabilitation program in

residential care homes for the elderly in the Netherlands1. Am J

Audiol 2013;22:186‑9.

Davis A, Smith P, Ferguson M, Stephens D, Gianopoulos I.

Acceptability, benefit and costs of early screening for hearing

disability: A study of potential screening tests and models.

Health Technol Assess 2007;11:1‑294.

Shi YH, Cao WX. Clinical applying of acoustics sensibility

screening for neonates. Nurs Res 2004;18:1274‑5.

Mason JA, Herrmann KR. Universal infant hearing screening by

automated auditory brainstem response measurement. Pediatrics


Aidan D, Avan P, Bonfiles P. Auditory screening in neonates by

means of transient evoked otoacoustic emissions: A report of

recording. Ann Otol Rhinol Laryngol 1999;108:25‑31.

Connolly JL, Carron JD, Roark SD. Universal newborn hearing

screening: Are we achieving the Joint Committee on Infant

Hearing (JCIH) objectives? Laryngoscope 2005;115:232‑6.

Erenberg A, Lemons J, Sia C, Trunkel D, Ziring P. Newborn

and infant hearing loss: Detection and intervention. American

Academy of Pediatrics. Task Force on Newborn and Infant

Hearing, 1998‑1999. Pediatrics 1999;103:527‑30.

Ravi R, Gunjawate DR, Yerraguntla K, Lewis LE, Driscoll C,

Rajashekhar B. Follow‑up in newborn hearing screening—A

systematic review. Int J Pediatr Otorhinolaryngol 2016;90:29‑36.

Li PC, Chen WI, Huang CM, Liu CJ, Chang HW, Lin HC.

Comparison of newborn hearing screening in well‑baby nursery

and NICU: A study applied to reduce referral rate in NICU.

PLoS One 2016;11:e0152028.

Vohr BR, Carty LM, Moore PE, Letourneau K. The Rhode

Island Hearing Assessment Program: Experience with statewide

hearing screening (1993‑1996). J Pediatr 1998;133:353‑7.

van Dommelen P, van Straaten HLM, Verkerk PH; Dutch

NICU Neonatal Hearing Screening Working Group. Ten‑year

quality assurance of the nationwide hearing screening

programme in Dutch neonatal intensive care units. Acta Paediatr


Smolkin T, Mick O, Dabbah M, Blazer S, Grakovsky G,

Gabay N, et al. Birth by cesarean delivery and failure on first

otoacoustic emissions hearing test. Pediatrics 2012;130:95‑100.