Vohr B R, Widen J E, Cone-Wesson B, Sininger Y S, Gorga M P, Folsom R C, Norton S J
Multicenter Consortium on Neonatal Hearing Screening, Seattle, Washington, USA.
Ear Hear. 2000 Oct;21(5):373-82. doi: 10.1097/00003446-200010000-00005.
The objective of this study was to describe the demographic data, medical status, and incidence of risk factors for hearing impairment in the neonatal intensive care unit (NICU) and well-baby populations in a multicenter prospective study designed to assess neonatal hearing impairment and to evaluate factors that might affect neonatal hearing test performance.
This was a prospective multicenter study funded by the National Institutes of Health-National Institute on Deafness and Other Communication Disorders to evaluate the effectiveness of auditory brain stem response, transient evoked otoacoustic emissions, and distortion product otoacoustic emissions for newborn hearing screening. Research staff at each site obtained informed consent and detailed demographic and medical data, including information on established risk factors for hearing loss on 4478 high-risk infants cared for in the NICU, 2348 infants from the well-baby nurseries with no risk factor, and 353 infants from the well-baby nurseries with risk factors. For follow-up purposes the sample was divided further to include a subgroup called selects. Selects were either infants from the well-baby nursery who had an established risk factor for hearing impairment (N = 353) or did not pass the neonatal hearing screen protocol (N = 80). In this study, we focus on the distribution of infants by nursery and risk factors only. Particular effort was made to enroll infants with risk factors for hearing loss in both the NICU and well-baby nurseries. Descriptive analyses are used to describe characteristics of this sample.
All 10 of the risk factors established by the Joint Committee on Infant Hearing in 1994 were identified in the NICU population. The four most common were ototoxic medications (44.4%), very low birth weight (17.8%), assisted ventilation > 5 days (16.4%), and low Apgar scores at 1 or 5 min (13.9%). In contrast, only six risk factors were present in the well-baby nurseries: family history (6.6%), craniofacial abnormalities (3.4%), low Apgar scores (2.8%), syndromes (0.5%), ototoxic medications (0.2%), and congenital infection (0.1%).
These descriptive risk factor data reflect both the newborn populations at the study sites and the bias for enrolling infants at risk for hearing loss. The high-risk NICU sample reflects the characteristics typically found in graduates of the NICU. The data summarized in this study will be used to assess the relationships between risk factor and hearing test outcome.
本研究旨在描述多中心前瞻性研究中新生儿重症监护病房（NICU）及健康婴儿群体的人口统计学数据、医疗状况和听力障碍风险因素的发生率，该研究旨在评估新生儿听力障碍，并评估可能影响新生儿听力测试表现的因素。
这是一项由美国国立卫生研究院-国立耳聋及其他交流障碍研究所资助的前瞻性多中心研究，旨在评估听觉脑干反应、瞬态诱发耳声发射和畸变产物耳声发射用于新生儿听力筛查的有效性。每个研究点的研究人员获取了知情同意书以及详细的人口统计学和医疗数据，包括4478名在NICU接受治疗的高危婴儿、2348名无风险因素的健康婴儿保育室婴儿以及353名有风险因素的健康婴儿保育室婴儿的已知听力损失风险因素信息。为了后续研究目的，样本进一步分为一个名为“精选组”的亚组。精选组包括有听力障碍既定风险因素的健康婴儿保育室婴儿（N = 353）或未通过新生儿听力筛查方案的婴儿（N = 80）。在本研究中，我们仅关注按保育室和风险因素划分的婴儿分布情况。特别努力招募了NICU和健康婴儿保育室中有听力损失风险因素的婴儿。描述性分析用于描述该样本的特征。
1994年婴儿听力联合委员会确定的所有10种风险因素在NICU群体中均有发现。最常见的四种是耳毒性药物（44.4%）、极低出生体重（17.8%）、辅助通气>5天（16.4%）以及1分钟或5分钟时阿氏评分低（13.9%）。相比之下，健康婴儿保育室中仅存在六种风险因素：家族病史（6.6%）、颅面异常（3.4%）、阿氏评分低（2.8%）、综合征（0.5%）、耳毒性药物（0.2%）和先天性感染（0.1%）。
这些描述性风险因素数据既反映了研究点的新生儿群体情况，也反映了招募有听力损失风险婴儿时存在的偏差。高危NICU样本反映了NICU毕业生中通常发现的特征。本研究总结的数据将用于评估风险因素与听力测试结果之间的关系。
