Page 47 - JCTR-11-4

Journal of Clinical and

Translational Research

ORIGINAL ARTICLE
Gender differences in otoacoustic emissions test

pass rates: Evidence from a general population
and twin study

1
Jose Miguel Sequi-Canet * , Jose Miguel Sequi-Sabater 2,3,4 , Victor Aparisi-
1
Climent 1 , Daniel Gomez-Sanchez , Carlos Miguel Angelats-Romero 1 , and
Marta Gomez-Delgado 1
1 Department of Pediatrics, Francesc de Borja University Hospital, Gandia, Valencia, Spain
2 Department of Rheumatology, La Ribera University Hospital, Alzira, Valencia, Spain
3 Department of Rheumatology, La Fe University Hospital, Valencia, Spain
4 Department of Medicine, Karolinska Institutet and University Hospital, Stockholm, Sweden

Abstract

Background: Evoked otoacoustic emissions are one of the most widely employed
techniques in assessing neonatal hearing. However, several factors may influence the
*Corresponding author: outcomes of this test. One such factor is gender, as previous research has shown that
Sequi-Canet Jose Miguel females tend to exhibit a greater otoacoustic response than males. Aim: This study
(sequi_jos@gva.es) evaluates whether gender influences the pass rate of the otoacoustic emissions test
Citation: Sequi-Canet JM, Sequi- in neonatal hearing screening, using data from both the general population and
Sabater JM, Aparisi-Climent V, twin pairs. Methods: Data from the Newborn Hearing Screening (NHS) program and
Gomez-Sanchez D, Angelats-
Romero CM, and Gomez- infant gender were collected between 2002 and 2023 from 22,825 healthy newborns
Delgado M. Gender differences in in the maternity or neonatal ward. Of these, 586 cases were from twin pregnancies.
otoacoustic emissions test pass A separate analysis was conducted for twins, distinguishing between same-sex
rates: Evidence from a general
population and twin study. J Clin and opposite-sex pairs. Results: A highly significant difference (p<0.0001) in NHS
Transl Res. 2025;11(4):41-50. pass rates was observed in favor of females, who demonstrated better responses
doi: 10.36922/jctr.8416 to the test. In the twin subgroup, analysis of the 112 discordant-sex pairs with
Received: January 6, 2025 differing test outcomes revealed a statistically significant result (p<0.023), further
supporting the positive effect of female sex on successfully passing the hearing
1st revised: February 25, 2025
screening test. Conclusion: Female newborns exhibit stronger otoacoustic emission
2nd revised: April 15, 2025 responses and higher pass rates in the NHS test compared to male newborns. These
Accepted: May 12, 2025 gender-based variations in otoacoustic emission responses may have important
implications for the NHS, as otoacoustic emissions are a commonly used screening
Published online: May 27, 2025
tool in neonatal hearing assessment. Relevance for patients: Recognizing and
Copyright: © 2025 Author(s). accounting for these gender-based differences in otoacoustic emission responses
This is an open-access article
distributed under the terms of the may inform modifications to screening program protocols, potentially improving the
Creative Commons AttributionNon- identification of hearing impairment in newborns.
Commercial 4.0 International (CC
BY-NC 4.0), which permits all
non-commercial use, distribution, Keywords: Newborn hearing screening; Gender; Otoacoustic emissions; Twins
and reproduction in any medium,
provided the original work is
properly cited.
Publisher’s Note: AccScience
Publishing remains neutral with 1. Introduction
regard to jurisdictional claims in
published maps and institutional Evoked otoacoustic emissions (EOAEs) are faint sounds generated within the
affiliations. inner ear by the cochlea’s outer hair cells in response to acoustic stimulation. Their

Volume 11 Issue 4 (2025) 41 doi: 10.36922/jctr.8416