<b>Auditory Outcomes in Neonates Born to Mothers with Preeclampsia: A Cross-Sectional Study</b>

Background: Neonatal hearing loss is a major global health concern, with an estimated incidence of 1–5 per 1000 live births. Maternal preeclampsia has been proposed as a risk factor due to uteroplacental insufficiency and intrauterine hypoxia, but limited evidence exists from low- and middle-income countries. Early detection through otoacoustic emissions (OAEs) is crucial to prevent long-term deficits in speech, cognition, and psychosocial development. Objective: To determine the frequency of hearing loss in neonates born to mothers with preeclampsia and explore associated maternal and neonatal factors. Methods: A cross-sectional observational study was conducted at the University of Lahore Teaching Hospital between March and September 2023. A total of 173 neonates of preeclamptic mothers were enrolled consecutively. Bilateral distortion product otoacoustic emissions (DPOAEs) were recorded within 48 hours of birth. Maternal and neonatal data were collected, and associations with OAE outcomes were analyzed using chi-square tests and odds ratios with 95% confidence intervals. Results: Forty neonates (23.1%) demonstrated absent bilateral DPOAE responses. Low birth weight was associated with a higher refer rate (30.8% vs 20.9%, OR 1.68, 95% CI: 0.74–3.81; p=0.21), though not statistically significant. Maternal comorbidities, infections, delivery mode, and neonatal sex showed no significant associations. Conclusion: Neonates of preeclamptic mothers demonstrated a high prevalence of abnormal OAE outcomes, indicating increased risk of early auditory dysfunction. Routine neonatal hearing screening should be prioritized in this high-risk group to enable timely intervention.