AccScience Publishing / JCTR / Online First / DOI: 10.36922/jctr.8416
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ORIGINAL ARTICLE

Gender differences in otoacoustic emissions test pass rates: Evidence from a general population and twin study

Jose Miguel Sequi-Canet1* ,  Jose Miguel Sequi-Sabater2,3,4 ,  Victor Aparisi-Climent1 ,  Daniel Gomez-Sanchez1 ,  Carlos Miguel Angelats-Romero1 ,  Marta Gomez-Delgado1
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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
JCTR, 8416 https://doi.org/10.36922/jctr.8416
Received: 6 January 2025 | Revised: 15 April 2025 | Accepted: 12 May 2025 | Published online: 27 May 2025
© 2025 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )
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Abstract

Background: Evoked otoacoustic emissions are one of the most widely employed techniques in assessing neonatal hearing. However, several factors may influence the outcomes of this test. One such factor is gender, as previous research has shown that females tend to exhibit a greater otoacoustic response than males. Aim: This study evaluates whether gender influences the pass rate of the otoacoustic emissions test in neonatal hearing screening, using data from both the general population and twin pairs. Methods: Data from the Newborn Hearing Screening (NHS) program and infant gender were collected between 2002 and 2023 from 22,825 healthy newborns in the maternity or neonatal ward. Of these, 586 cases were from twin pregnancies. A separate analysis was conducted for twins, distinguishing between same-sex and opposite-sex pairs. Results: A highly significant difference (p<0.0001) in NHS pass rates was observed in favor of females, who demonstrated better responses to the test. In the twin subgroup, analysis of the 112 discordant-sex pairs with differing test outcomes revealed a statistically significant result (p<0.023), further supporting the positive effect of female sex on successfully passing the hearing screening test. Conclusion: Female newborns exhibit stronger otoacoustic emission responses and higher pass rates in the NHS test compared to male newborns. These gender-based variations in otoacoustic emission responses may have important implications for the NHS, as otoacoustic emissions are a commonly used screening tool in neonatal hearing assessment. Relevance for patients: Recognizing and accounting for these gender-based differences in otoacoustic emission responses may inform modifications to screening program protocols, potentially improving the identification of hearing impairment in newborns.

Keywords
Newborn hearing screening
Gender
Otoacoustic emissions
Twins
Funding
None.
Conflict of interest
The authors declare that they have no conflicts of interest.
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Journal of Clinical and Translational Research, Electronic ISSN: 2424-810X Print ISSN: 2382-6533, Published by AccScience Publishing
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