{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T15:37:58Z","timestamp":1787672278614,"version":"build-2736575974"},"reference-count":30,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2020,11,2]],"date-time":"2020-11-02T00:00:00Z","timestamp":1604275200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Early detection of hearing loss in neonates is important for normal language development, especially for infants admitted to the neonatal intensive care unit (NICU) because the infants in NICU have a higher incidence of hearing loss than healthy infants. However, the risk factors of hearing loss in infants admitted to the NICU have not been fully acknowledged, especially in Korea, although they may vary according to the circumstances of each country and hospital. In this study, the risk factors of hearing loss in NICU infants were analyzed by using the newborn hearing screening (NHS) and the diagnostic auditory brainstem response (ABR) test results from a 13-year period. A retrospective chart review was performed using a list of NICU infants who had performed NHS from 2004 to 2017 (n = 2404) in a university hospital in Korea. For the hearing loss group, the hearing threshold was defined as 35 dB nHL or more in the ABR test performed in infants with a \u2018refer\u2019 result in the NHS. A four multiple number of infants who had passed the NHS test and matched the age and gender of the hearing loss group were taken as the control group. Various patient factors and treatment factors were taken as hearing loss related variables and were analyzed and compared. From the 2404 infants involved, the prevalence of hearing loss was 1.8% (n = 43). A comparison between the hearing loss group (n = 43) and the control group (n = 172) revealed that history of sepsis, peak total bilirubin, duration of vancomycin use, days of phototherapy, and exposure to loop-inhibiting diuretics were significantly different, and can be verified as significant risk factors for hearing loss in NICU infants.<\/jats:p>","DOI":"10.3390\/ijerph17218082","type":"journal-article","created":{"date-parts":[[2020,11,2]],"date-time":"2020-11-02T19:51:31Z","timestamp":1604346691000},"page":"8082","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Analysis of the Risk Factors Associated with Hearing Loss of Infants Admitted to a Neonatal Intensive Care Unit: A 13-Year Experience in a University Hospital in Korea"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8464-2665","authenticated-orcid":false,"given":"Kyu Young","family":"Choi","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology-Head and Neck Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul 07441, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bum Sang","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology-Head and Neck Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul 07441, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyo Geun","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology-Head and Neck Surgery, Hallym Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2274-2799","authenticated-orcid":false,"given":"Su-Kyoung","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology-Head and Neck Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul 07441, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,11,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1161","DOI":"10.1542\/peds.102.5.1161","article-title":"Language of early- and later-identified children with hearing loss","volume":"102","author":"Sedey","year":"1998","journal-title":"Pediatrics"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"American Academy of Pediatrics, Joint Committee on Infant Hearing (2007). Year 2007 position statement: Principles and guidelines for early hearing detection and intervention programs. Pediatrics, 120, 898\u2013921.","DOI":"10.1542\/peds.2007-2333"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1093\/deafed\/ent043","article-title":"Principles and guidelines for early intervention after confirmation that a child is deaf or hard of hearing","volume":"19","year":"2014","journal-title":"J. Deaf Stud. Deaf Educ."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"999","DOI":"10.1016\/j.ijporl.2010.05.024","article-title":"Risk factors for sensorineural hearing loss in NICU infants compared to normal hearing NICU controls","volume":"74","author":"Coenraad","year":"2010","journal-title":"Int. J. Pediatr. Otorhinolaryngol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1016\/j.jcomdis.2004.04.008","article-title":"Levels of evidence: Universal newborn hearing screening (UNHS) and early hearing detection and intervention systems (EHDI)","volume":"37","year":"2004","journal-title":"J. Commun. Disord."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"925","DOI":"10.1016\/j.ijporl.2011.04.007","article-title":"Risk factors associated with hearing loss in infants: An analysis of 5282 referred neonates","volume":"75","author":"Bielecki","year":"2011","journal-title":"Int. J. Pediatr. Otorhinolaryngol."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Colella-Santos, M.F., Hein, T.A., de Souza, G.L., do Amaral, M.I., and Casali, R.L. (2014). Newborn hearing screening and early diagnostic in the NICU. BioMed Res. Int., 845308.","DOI":"10.1155\/2014\/845308"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Joint Committee on Infant Hearing, American Academy of Audiology, American Academy of Pediatrics, American Speech-Language-Hearing Association, and Directors of Speech and Hearing Programs in State Health and Welfare Agencies (2000). Year 2000 position statement: Principles and guidelines for early hearing detection and intervention programs. Joint Committee on Infant Hearing, American Academy of Audiology, American Academy of Pediatrics, American Speech-Language-Hearing Association, and Directors of Speech and Hearing Programs in State Health and Welfare Agencies. Pediatrics, 106, 798\u2013817.","DOI":"10.1542\/peds.106.4.798"},{"key":"ref_9","unstructured":"Public Health England (2018). NHS public health functions agreement 2018\u201319. Service Specification No.20 NHS Newborn Hearing Screening Programme, Public Health England."},{"key":"ref_10","unstructured":"The Korean Audiological Society (2018). Korean Newborn Hearing Screening Guideline Update, Hyun Publisher. [2nd ed.]."},{"key":"ref_11","unstructured":"Joint Committee on Infant Hearing (1994). 1994 Position Statement. ASHA, 36, 38\u201341."},{"key":"ref_12","unstructured":"Martines, F. (2017). Audiological Risk Factors and Screening Strategies in NICU Infants. Neonatal Intensive Care Units (NICUs): Clinical and Patient Perspectives, Levels of Care and Emerging Challenges, Nova."},{"key":"ref_13","first-page":"1001","article-title":"NICU Infants & SNHL: Experience of a western Sicily tertiary care centre","volume":"35","author":"Gazia","year":"2019","journal-title":"Acta Med. Mediterr."},{"key":"ref_14","unstructured":"Martines, F. (2017). Hearing Loss in Neonatal Intensive Care Units (NICUs): Follow-Up Surveillance. Neonatal Intensive Care Units (NICUs): Clinical and Patient Perspectives, Levels of Care and Emerging Challenges, Nova."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"339","DOI":"10.2307\/2528794","article-title":"Individual matching with multiple controls in the case of all-or-none responses","volume":"25","author":"Miettinen","year":"1969","journal-title":"Biometrics"},{"key":"ref_16","unstructured":"World Health Organization (2010). Newborn and Infant Hearing Screening: Current Issues and Guiding Principles for Action 2010, World Health Organization."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Li, P.C., Chen, W.I., Huang, C.M., Liu, C.J., Chang, H.W., and Lin, H.C. (2016). Comparison of Newborn Hearing Screening in Well-Baby Nursery and NICU: A Study Applied to Reduce Referral Rate in NICU. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0152028"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1097","DOI":"10.1111\/j.1651-2227.2011.02230.x","article-title":"Ten-year quality assurance of the nationwide hearing screening programme in Dutch neonatal intensive care units","volume":"100","author":"Verkerk","year":"2011","journal-title":"Acta Paediatr."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1542\/peds.101.2.221","article-title":"Universal infant hearing screening by automated auditory brainstem response measurement","volume":"101","author":"Mason","year":"1998","journal-title":"Pediatrics"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"American Academy of Pediatrics, Subcommittee on Hyperbilirubinemia (2004). Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics, 114, 297\u2013316.","DOI":"10.1542\/peds.114.1.297"},{"key":"ref_21","first-page":"605828","article-title":"Hearing and neurological impairment in children with history of exchange transfusion for neonatal hyperbilirubinemia","volume":"2014","author":"Poblano","year":"2014","journal-title":"Int. J. Pediatr."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1097\/01.mlg.0000154724.00787.49","article-title":"Universal newborn hearing screening: Are we achieving the Joint Committee on Infant Hearing (JCIH) objectives?","volume":"115","author":"Connolly","year":"2005","journal-title":"Laryngoscope"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1542\/peds.2014-0987","article-title":"Incidence, etiology, and outcomes of hazardous hyperbilirubinemia in newborns","volume":"134","author":"Kuzniewicz","year":"2014","journal-title":"Pediatrics"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1839","DOI":"10.1097\/MAO.0000000000000615","article-title":"Risk indicators for congenital and delayed-onset hearing loss","volume":"35","author":"Kraft","year":"2014","journal-title":"Otol. Neurotol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"852","DOI":"10.1002\/lary.21430","article-title":"Risk factors for auditory neuropathy spectrum disorder in NICU infants compared to normal-hearing NICU controls","volume":"121","author":"Coenraad","year":"2011","journal-title":"Laryngoscope"},{"key":"ref_26","first-page":"MC01","article-title":"Hearing screening in a tertiary care hospital in India","volume":"9","author":"Kumar","year":"2015","journal-title":"J. Clin. Diagn. Res."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1159\/000500316","article-title":"Risk Factors and Prognostic Factors of Hearing Impairment in Neonatal Intensive Care Unit-Treated Infants","volume":"24","author":"Umehara","year":"2019","journal-title":"Audiol. Neurootol."},{"key":"ref_28","first-page":"116","article-title":"The Prevalence of Hearing Loss Among Babies in the Neonatal Intensive Care Unit in a Tertiary Hospital in Malaysia","volume":"35","author":"Abdullah","year":"2020","journal-title":"Medeni Med. J."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Yun, C., Wang, Z., Gao, J., He, P., Guo, C., Chen, G., and Zheng, X. (2017). Prevalence and Social Risk Factors for Hearing Impairment in Chinese Children-A National Survey. Int. J. Environ. Res. Public Health, 14.","DOI":"10.3390\/ijerph14010088"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Vos, B., Senterre, C., Lagasse, R., SurdiScreen, G., and Leveque, A. (2015). Newborn hearing screening programme in Belgium: A consensus recommendation on risk factors. BMC Pediatr., 15.","DOI":"10.1186\/s12887-015-0479-4"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/21\/8082\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T10:28:18Z","timestamp":1760178498000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/21\/8082"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11,2]]},"references-count":30,"journal-issue":{"issue":"21","published-online":{"date-parts":[[2020,11]]}},"alternative-id":["ijerph17218082"],"URL":"https:\/\/doi.org\/10.3390\/ijerph17218082","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,11,2]]}}}