P2.H156: Newborn Hearing Assessment and Neonatal Abstinence Syndrome: A Retrospective Chart Review at a Large Urban Safety-Net Hospital

Background: Neonatal abstinence syndrome (NAS) is a postnatal withdrawal syndrome affecting infants who have been exposed to opioids in-utero. The incidence rate of NAS is approximately 6 in 1000 newborn hospital stays. Despite its significant impact on patients, their families, and the healthcare system, the long-term impacts of NAS remain relatively unknown. Specifically, despite the documented association between opioid use and sensorineural hearing loss in adults, there has been limited focus on the impact of NAS on otologic function including hearing impairment. The primary objective of this retrospective chart review is to measure the association between neonatal abstinence syndrome and failed newborn hearing screen at a single large urban safety-net hospital.

Methods: We collected demographic and clinical characteristics of all infants born between May 2015- April 2022. Exclusion criteria included infants who did not receive a newborn hearing screen and infants of incarcerated birthing parents. We used multivariable logistic regressions to assess the relationship between NAS and failed newborn hearing screen while controlling for known risk factors for hearing loss. Risk factors for hearing loss included NICU stay greater than 5 days, intrauterine infections (toxoplasmosis, rubella, HSV, CMV), neonatal bacterial infections, neonatal meningitis, and craniofacial anomalies. Additionally, we used univariable logistic regressions to assess the relationship between demographic characteristics and failed newborn hearing screen.

Results: Of the 18,676 patients that met selection criteria, 2.9% (n=532) had a failed newborn hearing screen and 3.1% (n=585) had a diagnosis of NAS. 3.4% of patients with NAS (n=20) had a failed newborn hearing screen. Controlling for known risk factors for hearing loss, patients who had NAS had greater odds of a failed newborn hearing screen, although this association was not significant (OR= 1.19, 95% CI [0.73-1.83]). Additionally, univariable analysis of demographic characteristics revealed that patients who were Black/African American (OR=1.48 95% CI [1.23-1.78]), used Medicaid/Public insurance (OR=1.57, 95% CI [1.28-1.93]), or had a birthing parent less than 25 years old (OR=1.49, 95% CI [1.21-1.82]) had increased odds of a failed newborn hearing screen.

Conclusion: Our preliminary findings suggest that there is no significant association between neonatal abstinence syndrome and failed newborn hearing screen at our large, urban safety-net hospital. Further research is necessary to determine how NAS in combination with other clinical or social factors may impact newborn hearing screens, especially as children with NAS and their families experience heightened barriers to receiving both preventative and specialty care.