Factors Affecting Successful Completion of the Neonatal Hearing Screening Test (Otoacoustic Emission Test) in the First Attempt in Healthy Term Newborns Prior to Discharge from the Hospital

Introduction: Hearing loss is one of the most prevalent congenital disorders in neonates. Infants with untreated hearing loss usually struggle greatly in terms of emotional, social, and verbal development. Early identification via neonatal hearing tests and preventive strategies have been advised in order to lessen the negative impacts of congenital hearing loss on the infant's life.Objectives: To assess the factors affecting the success of performing an otoacoustic emissions(OAE) test in stable term neonates.Methodology: A descriptive type of cross sectional study was carried out at Sri Jayewardenepura Hospital from 01/06/20222 to 01/09/2022. All healthy term neonates were included, and preterm and neonates associated with other medical conditions were excluded. Results: Out of 455 neonates, 422 (92.7%) were able to successfully complete the OAE test. 85.1% (n = 365) had a bedside sound level of 60dB-65 with a mean value of 61.62 dB at the time of OAE testing (p = 0.030). 134 (29.5%) neonates were breastfed (p = 0.281) and the majority of the newborns (n=367, 80.7%) were sleeping (p = 0.460) during the OAE test. Considering the factors affecting the successful outcome of the OAE testing, there is a statistically significant association with crying (p<0.001,OR(95% CI) = 0.026 (0.010- 0.068)), struggling (p = 0.003), OR (95% CI) = 0.194 (0.58 - 0.647), debris in the external ear (p<0.001) with OR (95% CI) = 0.019 (0.005 - 0.75), throat secretions (p <0.001), and OR (95% CI) of 0. 122 (0.034 - 0.442), external ear abnormalities (p = 0.005), and OR (95% CI) = 0.169(0.041 - 0.686).Conclusion: Crying, struggling, debris in the external ear, throat secretions, external ear abnormalities, and the sound level (dB) at the time of the test are the factors that are statistically significantly associated with the success of the OAE test. Thus, to achieve a successful OAE test, it is pivotal to keep the baby in a calm state with an optimal bedside sound level.