Comprehensive evaluation of risk factors for neonatal hearing loss in a large Brazilian cohort

Abstract
Objectives To determine the incidence and risk factors of hearing loss (HL) in Brazilian neonates. Study design 11,900 neonates were screened for hearing and congenital CMV (cCMV). Low and high-risk babies who did not pass their hearing screening and infants with cCMV were scheduled for a diagnostic audiologic evaluation. Results The incidence of HL was 2 per 1000 live-born infants (95% CI: 1–3). HL was higher in high-risk neonates than in low risk babies (18.6 vs. 0.3/1000 live births, respectively). Among infants exposed to isolated risk factors, association of HL with craniofacial abnormalities/syndromes (RR = 24.47; 95% CI: 5.9–100.9) and cCMV (RR = 9.54; 95% CI: 3.3–27.7) were observed. HL was 20 to 100-fold more likely in neonates exposed to ototoxic drugs in combination with cCMV or craniofacial/congenital anomalies. Conclusions Strategies for the prevention of cCMV and exposure to ototoxic drugs may decrease the incidence of HL in this population.