Risk factors associated with hearing loss in neonates: A retrospective cross-sectional study from Qatar.

Background: Hearing loss (HL) affects approximately 3 in every 1,000 infants worldwide. However, current Early Hearing Detection and Intervention (EHDI) guidelines may not fully account for region-specific neonatal risk factors. In the Middle East, conditions such as gestational diabetes mellitus (GDM), pre-eclampsia, and consanguinity are highly prevalent but remain underexplored in HL research. This study investigates the association between these and other neonatal risk factors and HL outcomes in newborns in Qatar. Methods: A retrospective cross-sectional review of electronic health records was conducted for 5,098 neonates born between March 2019 and March 2022 at a tertiary hospital in Qatar. After exclusions, 4,126 neonates were analyzed. Maternal and neonatal risk factors, along with newborn hearing screening outcomes, were assessed using Fisher's exact test, Chi-square test, and logistic regression analysis. Results: Overall, 6% of neonates failed the hearing screening (n = 248). The most common risk factors were GDM (34.5%), hyperbilirubinemia (21.0%), and gentamicin exposure (9.6%). However, GDM showed no significant association with failed screening. The strongest association was found with Down syndrome (odds ratio [OR] = 14.215; 95% confidence interval [CI]: 4.286-47.151; p < 0.001), followed by cleft lip/palate (OR = 4.371; 95% CI: 1.384-13.801; p < 0.012), and high-risk categorization (OR = 1.973; 95% CI: 1.266-3.076;p < 0.003). Conclusion: Contrary to expectations, GDM and hyperbilirubinemia were not associated with an increased risk of HL. In contrast, Down syndrome and cleft lip/palate showed significant associations with HL risk. These findings highlight the importance of incorporating regionally relevant risk factors-such as genetic syndromes and craniofacial anomalies-into local Early Hearing Detection and Intervention (EHDI) frameworks. Contextualizing hearing screening within the Gulf region may enhance early detection and optimize care pathways.