Graduate Student Michigan State University College of Human Medicine East Lansing, Michigan, United States
Background: Newborn hearing screening failure helps identify infants with hearing loss, but screening failures also occur among infants without hearing loss. Some speculate these false positive results reflect neurodevelopmental disorder risk. Preterm birth (PTB), a known neurodevelopmental risk factor, has been associated with false positive results at initial screening. We aim to further characterize this association by stratifying PTB by gestational age and delivery circumstance. Objective: To evaluate the association between preterm birth (defined by gestational age and delivery circumstance) and false positive newborn hearing screening results in a large, population-based sample of children from Michigan. Design/Methods: We analyzed birth certificate and Early Hearing Detection & Intervention data from the Michigan Dept. of Health & Human Services (2007-2015; n=919,363). We restricted our analysis to singleton live births with available hearing screening data and obstetric estimates of gestational age (n=655,079). We used two separate logistic regression models to evaluate the association of PTB defined by gestational age (extreme: < 28 weeks; moderate: 29-33 weeks; late: 34-36 weeks) and delivery circumstance (spontaneous, medically indicated) with false positive findings, using full-term birth (> 37 weeks) as the referent group. Results: Approximately 4% infants had false positive findings. All gestational age PTB categories were associated with this phenomenon (extreme: OR=3.4, 95%CI 3.1,3.8; moderate: OR=1.1, 95%CI 1.0, 1.2; late: OR=1.4, 95%CI 1.4, 1.5). Spontaneous and medically indicated PTB were also associated with false positive findings (OR=1.5, 95% CI 1.4,1.6; OR=1.3, 95% CI 1.2,1.4, respectively); these estimates did not differ from one another. All results persisted following adjustment for socio-demographic, pregnancy, and antepartum factors except for moderate PTB (OR=1.0, 95%CI 0.9, 1.1).
Conclusion(s): PTB is associated with false positive hearing screening results, though findings may vary more by gestational age than delivery circumstance. Further research is needed to investigate factors underlying these differences and whether they correlate with neurodevelopmental disorder diagnoses.
