Page 54 - JCTR-11-4

Journal of Clinical and
Translational Research Female are better in otoacoustic emissions tests

interest. However, due to the statistical need for sufficiently • Follow-up adjustments: For borderline results,
large study groups, this could only be achieved with large especially in male neonates, implement a second
cohorts of twins collected through multicenter studies. screening before labeling a potential issue. Conversely,
Another limitation arises from the retrospective nature a stricter follow-up protocol could be applied for
of this study, which prevents us from investigating other females with borderline results to ensure the subtle
factors that may affect male newborns and have not yet issues are not overlooked.
been considered. A prospective study with modifications Such measures would allow for a more personalized
to the pass criteria based on sex could shed more light on approach. They may improve the results of NHS, reducing
hidden factors that might influence the results. the number of neonates who need to be rescheduled for a
retest, as well as the associated anxiety and the possibility
5. Conclusion of losing patients during follow-up. By understanding
The existing literature indicates that female newborns and incorporating these gender differences, healthcare
tend to have stronger OAE responses compared to male providers can enhance the effectiveness of NHS programs,
newborns. Studies suggest a complex interaction between ensuring better outcomes for all infants.
genetic and hormonal factors in auditory development,
with both contributing to the differences observed in OAEs. Acknowledgments
This gender-based variation in OAE responses could The authors would like to thank the Pediatric Department
have important implications for NHS programs, as these at Francesc de Borja Hospital, Gandia.
tests are commonly used to identify hearing impairments
in infants. The data in this study suggest that female Funding
newborns exhibit stronger OAE responses and pass rates None.
on the test compared to male newborns.

The stronger OAE responses observed in female newborns Conflict of interest
lead to higher pass rates on initial NHSs. Conversely, male The authors declare that they have no conflicts of interest.
newborns may be more likely to fail the initial screening,
even in the absence of true hearing impairment. Author contributions
Changes to National Hearing Screening protocols Conceptualization: Jose Miguel Sequi-Canet, Jose Miguel
should be evaluated to improve the reliability and Sequi-Sabater
specificity of neonatal hearing screening. Data curation: Jose Miguel Sequi-Sabater, Victor Aparisi-
By acknowledging and accounting for these gender- Climent
based differences in OAE responses, screening programs Investigation: Daniel Gomez-Sanchez, Carlos Miguel
may be able to improve the identification of hearing Angelats-Romero
impairments, particularly milder forms, and ensure that Methodology: Daniel Gomez-Sanchez, Marta Gomez-
affected children receive the early intervention services they Delgado
need to support their language and cognitive development. Supervision: Jose Miguel Sequi-Canet, Marta Gomez-
Delgado
Among other measures, the “pass” criteria could be Writing – original draft: Jose Miguel Sequi-Canet
made more flexible to account for the observed differences. Writing – review & editing: Jose Miguel Sequi-Sabater,
For instance: Daniel Gomez-Sanchez, Carlos Miguel Angelats-
• Sex-specific pass thresholds: Adjusting the amplitude Romero, Marta Gomez-Delgado
or response time thresholds for OAEs based on the
neonate’s sex. Increasing the stimulus could also Ethics approval and consent to participate
be considered in males to overcome these gender
differences. This would help reduce false positives in This retrospective study was approved by the ethical
male neonates and false negatives in females. committee of the Francesc de Borja Hospital in Gandia
• Contextual considerations: Incorporating additional on July 15, 2019, with the code 12/2019. Parental verbal
factors such as birth method (e.g., cesarean versus consent was obtained prior to screening.
vaginal delivery), discharge day, and breastfeeding Consent for publication
status when interpreting OAE results. These contextual
factors can influence the robustness of OAE responses Datasets were anonymized before analysis, and parents
and pass rate. gave consent to publication the data.

Volume 11 Issue 4 (2025) 48 doi: 10.36922/jctr.8416