Preterm Delivery and Its Association with False Positive, Auditory Brainstem Response (ABR)-Based Newborn Hearing Screening Findings

摘要

Newborn hearing screening failure can occur in infants without hearing loss; these false-positive (FP) results have been speculated to reflect neurodevelopmental disorder risk. Preterm birth (PTB), a known neurodevelopmental risk factor, has been associated with FP at initial screening. We aim to further characterize this association by stratifying PTB by gestational age and delivery circumstance. To do this, 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 ABR-based hearing screening data and obstetric estimates of gestational age (n = 655,079). We then used logistic regression to evaluate the association of PTB defined by gestational age (extreme: 28 weeks; moderate: 28–34 weeks; late: 34–36 weeks) and delivery circumstance (spontaneous, medically indicated) with FP, using full-term birth (≥ 37 weeks) as the referent group. Approximately 4% of infants had FP findings. All gestational age categories were associated with this phenomenon (extreme: OR = 4.2, 95% CI 3.7, 4.7; moderate: OR = 1.2, 95% CI 1.1, 1.3; late: 1.6, 95% CI 1.5, 1.7). Spontaneous and medically indicated PTB were also associated with FP (OR = 1.7, 95% CI 1.6, 1.8; OR = 1.4, 95% CI 1.3, 1.5, respectively). All results persisted following adjustment for socio-demographic and antepartum factors except for moderate PTB (OR = 1.0, 95% CI 0.9, 1.1), though sensitivity analyses suggested marked heterogeneity within this group. Further research is needed to investigate factors underlying these differences and whether they correlate with neurodevelopmental disorder diagnoses.