Effects of auditory pathway maturation on hearing loss diagnosis.

PURPOSE: The maturation of auditory pathways in newborns, particularly in pre-terms, is a crucial process influencing the accuracy and timeliness of early audiological diagnosis. The aim of this study was to investigate the effect of postnatal auditory pathway maturation on hearing loss diagnosis by comparing early and later ABR assessments in pre-term and full-term newborns. METHODS: Seventy-eight newborns (156 ears) were enrolled and divided by gestational age. All underwent initial screening, clinical Auditory Brainstem Response (ABR), tympanometry, and evaluation of diagnostic timing. Statistical analyses were performed with Jamovi (v.2.3.28). RESULTS: In full-term newborns, the initial screening significantly predicted ABR outcomes, whereas no such correlation emerged in pre-terms. However, pre-terms showed a significant improvement in ABR thresholds over time, consistent with postnatal maturational effects on auditory pathway function. Additionally, pathological tympanograms (type B) were associated with a delayed diagnosis. CONCLUSIONS: These findings stress the need for tailored protocols and extended follow-up in pre-term newborns, as well as early detection of middle ear conditions to minimize both under- and over-diagnosis.