Lima Gisele M L, Marba Sérgio T M, Santos Maria Francisca C
Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil.
J Pediatr (Rio J). 2006 Mar-Apr;82(2):110-4. doi: 10.2223/JPED.1457.
Investigate the prevalence of hearing impairment in newborns hospitalized at the Intensive and Intermediate Care Unit at the Women's Comprehensive Health Center Neonatology Service (UNICAMP) and associated risk factors.
979 newborn babies were assessed between January 2000 and January 2003, through automated auditory brainstem response (AABR) (ALGO 2e color screener). The result was considered normal when the newborn showed response to a 35dBNA signal bilaterally. The prevalence of AABR impairment and the odds ratio were analyzed with a 95% confidence interval using bivariate analysis. To identify the independent risk factors for hearing alterations, multivariate analyses were used with logistic regression.
The prevalence of AABR impairment was 10.2%, of which 5.3% was unilateral and 4.9% bilateral. From the multivariate analyses, the following observations were made: family history of congenital hearing loss (OR = 5.192; p = 0.016), craniofacial deformity (OR = 5.530; p < 0.001), genetic syndromes associated with hearing loss (OR = 4.212; p < 0.001), weight below 1,000 g (OR = 3.230; p < 0.001), asphyxia (OR = 3.532; p < 0.001), hyperbilirubinemia (OR = 4.099; p = 0.002) and use of mechanical ventilation (OR = 1.826; p < 0.031) were the indicators that best characterized the group at risk for hearing impairment.
The prevalence of hearing impairment using AABR is high. Therefore, it is essential for all newborns who present isolated or associated risk factors to undergo hearing screening in situations in which it is not possible to have universal hearing screening.
调查在妇女综合健康中心新生儿科服务部（坎皮纳斯州立大学）重症监护和中级护理病房住院的新生儿听力障碍的患病率及相关危险因素。
在2000年1月至2003年1月期间，通过自动听性脑干反应（AABR）（ALGO 2e彩色筛查仪）对979名新生儿进行评估。当新生儿双侧对35dBNA信号有反应时，结果被认为正常。使用双变量分析，以95%置信区间分析AABR损伤的患病率和比值比。为确定听力改变的独立危险因素，采用逻辑回归进行多变量分析。
AABR损伤的患病率为10.2%，其中单侧为5.3%，双侧为4.9%。通过多变量分析得出以下观察结果：先天性听力损失家族史（OR = 5.192；p = 0.016）、颅面畸形（OR = 5.530；p < 0.001）、与听力损失相关的遗传综合征（OR = 4.212；p < 0.001）、体重低于1000g（OR = 3.230；p < 0.001）、窒息（OR = 3.532；p < 0.001）、高胆红素血症（OR = 4.099；p = 0.002）和使用机械通气（OR = 1.826；p < 0.031）是最能表征听力障碍风险组的指标。
使用AABR检测出的听力障碍患病率很高。因此，对于所有存在孤立或相关危险因素的新生儿，在无法进行普遍听力筛查的情况下进行听力筛查至关重要。
