{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T06:20:43Z","timestamp":1783405243826,"version":"3.54.6"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T00:00:00Z","timestamp":1783382400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The potential risk factors for concurrent newborn hearing screening and genetic screening remain unclear, posing challenges to the prevention of hearing loss. Although gestational age and birth weight are known to influence hearing development, their associations with newborn hearing screening referral remain controversial due to limited large-scale validation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective population-based cohort study included 76,460 newborns who underwent concurrent newborn and genetic screening. Restricted cubic splines and piecewise linear models were used to identify threshold effects in the associations of birth weight and gestational age with initial hearing screening referral, second hearing screening outcomes, and genetic screening results. Sensitivity analyses were conducted by including sex and Apgar scores.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We identified non-linear, U-shaped associations between birth weight, gestational age and the odds of referral at initial hearing screening. A birth weight of 3,297\u202fg and gestational age of 39.19\u202fweeks were key change points. Infants above or below these points had increased odds of referral at initial hearing screening. Neither second hearing nor genetic screening results showed significant associations with both factors. Sex-stratified analysis showed male infants had higher odds of referral at initial hearing screening, with similar non-linear patterns observed for gestational age. Adjusting for Apgar scores confirmed these results, with the thresholds at a birth weight of 3,297\u202fg and gestational age of 39.27\u202fweeks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Birth weight and gestational age were associated with initial hearing screening referral only. The lowest referral odds occurred around 3.3\u202fkg and 39\u202fweeks of gestation, which may help identify newborns who require closer follow-up after initial screening.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1879289","type":"journal-article","created":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T05:46:15Z","timestamp":1783403175000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Nonlinear associations of birth weight and gestational age with initial newborn hearing screening referral in a large Chinese neonatal cohort"],"prefix":"10.3389","volume":"14","author":[{"given":"Xiaozhe","family":"Yang","sequence":"first","affiliation":[{"name":"Key Laboratory of Otolaryngology Head and Neck Surgery (Capital Medical University), Ministry of Education","place":["Beijing, China"]},{"name":"Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical 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Surgery, Beijing Tongren Hospital, Capital Medical University","place":["Beijing, China"]},{"name":"Beijing Institute of Otolaryngology","place":["Beijing, China"]},{"name":"Centre for Ear Sciences, Medical School, The University of Western Australia","place":["Crawley, WA, Australia"]},{"name":"Ear Science Institute Australia","place":["Subiaco, WA, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lihui","family":"Huang","sequence":"additional","affiliation":[{"name":"Key Laboratory of Otolaryngology Head and Neck Surgery (Capital Medical University), Ministry of Education","place":["Beijing, China"]},{"name":"Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University","place":["Beijing, China"]},{"name":"Beijing Institute of Otolaryngology","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Demin","family":"Han","sequence":"additional","affiliation":[{"name":"Key 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