Dear Lactnet Friends: Birth by Cesarean Delivery and Failure on First Otoacoustic Emissions Hearing Test 1. Tatiana Smolkin<http://pediatrics.aappublications.org/search?author1=Tatiana+Smolkin&sortspec=date&submit=Submit>, MDa<http://pediatrics.aappublications.org/content/130/1/e95.abstract#aff-1> ,b<http://pediatrics.aappublications.org/content/130/1/e95.abstract#aff-4> , 2. Orna Mick<http://pediatrics.aappublications.org/search?author1=Orna+Mick&sortspec=date&submit=Submit> c<http://pediatrics.aappublications.org/content/130/1/e95.abstract#aff-2> , 3. Maisam Dabbah<http://pediatrics.aappublications.org/search?author1=Maisam+Dabbah&sortspec=date&submit=Submit> a<http://pediatrics.aappublications.org/content/130/1/e95.abstract#aff-1> ,b<http://pediatrics.aappublications.org/content/130/1/e95.abstract#aff-4> , 4. Shraga Blazer<http://pediatrics.aappublications.org/search?author1=Shraga+Blazer&sortspec=date&submit=Submit>, MDa<http://pediatrics.aappublications.org/content/130/1/e95.abstract#aff-1> ,b<http://pediatrics.aappublications.org/content/130/1/e95.abstract#aff-4> , 5. Galina Grakovsky<http://pediatrics.aappublications.org/search?author1=Galina+Grakovsky&sortspec=date&submit=Submit> c<http://pediatrics.aappublications.org/content/130/1/e95.abstract#aff-2> , 6. Noah Gabay<http://pediatrics.aappublications.org/search?author1=Noah+Gabay&sortspec=date&submit=Submit> c<http://pediatrics.aappublications.org/content/130/1/e95.abstract#aff-2> , 7. Arie Gordin<http://pediatrics.aappublications.org/search?author1=Arie+Gordin&sortspec=date&submit=Submit>, MDb<http://pediatrics.aappublications.org/content/130/1/e95.abstract#aff-4> ,d<http://pediatrics.aappublications.org/content/130/1/e95.abstract#aff-3>, and 8. Imad R. Makhoul<http://pediatrics.aappublications.org/search?author1=Imad+R.+Makhoul&sortspec=date&submit=Submit>, MD, PhDa<http://pediatrics.aappublications.org/content/130/1/e95.abstract#aff-1> ,b<http://pediatrics.aappublications.org/content/130/1/e95.abstract#aff-4> + <http://pediatrics.aappublications.org/content/130/1/e95.abstract#>Author Affiliations 1. aDepartment of Neonatology, Meyer Children’s Hospital, and 2. cAudiology Clinic, and 3. dDepartment of Otolaryngology, Rambam Health Care Campus, Haifa, Israel; and 4. bRappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa, Israel ABSTRACT *BACKGROUND:* Neonatal hearing screening occasionally fails. We noticed that infants born by cesarean delivery (CD) appeared to fail the first otoacoustic emissions (OAE) test more frequently than infants delivered vaginally (VD). This might increase maternal anxiety. We aimed to evaluate the influence of mode of delivery on failure to pass the first OAE. *METHODS:* Overall, 1653 infants of >35 weeks’ gestation were evaluated. OAE was performed before discharge. Perinatal-neonatal variables and results of OAE were recorded retrospectively. *RESULTS:* Compared with VD infants, CD infants had lower gestational age and 1-minute Apgar, more small for gestational age (SGA), and earlier age at first OAE. Univariate analysis: CD, male gender, gestational age 35 to 37 weeks, birth weight ≤2500 g, SGA, and younger age at first OAE were significantly associated with failed first OAE. In infants weighing 2501 to 4000 g, CD infants had 3-fold higher rates of failed first OAE in comparison with VD infants (20.7% vs 7.1%) before 48 hours of age. In the multivariate analysis, variables independently significantly associated with failed first OAE were male gender (odds ratio [OR] 1.42 [1.02–1.98]), CD (emergency CD: OR 3.18 [2.21–4.57], elective CD: OR 3.32 [2.04–5.42]), age 12 to 23 hours at first OAE (OR 3.1 [2.1–4.58]) and SGA (OR 2.2 [1.15–4.28]). *CONCLUSIONS:* CD infants had significantly higher failure rates on first OAE. We speculate that CD is accompanied by retained fluid in middle ear which may impair neonatal hearing. The timing of first OAE after CD should preferably be postponed beyond 48 hours of age to improve OAE passage and minimize maternal anxiety and costs. warmly, Nikki Lee RN, BSN, Mother of 2, MS, IBCLC, CCE, CIMI, ANLC, CKC craniosacral therapy practitioner www.breastfeedingalwaysbest.com *********************************************** Archives: http://community.lsoft.com/archives/LACTNET.html To reach list owners: [log in to unmask] Mail all list management commands to: [log in to unmask] COMMANDS: 1. To temporarily stop your subscription write in the body of an email: set lactnet nomail 2. To start it again: set lactnet mail 3. To unsubscribe: unsubscribe lactnet 4. To get a comprehensive list of rules and directions: get lactnet welcome