Department of Pediatrics, University of British Columbia, Vancouver, Canada.
Acta Paediatr. 2012 Feb;101(2):e48-54. doi: 10.1111/j.1651-2227.2011.02437.x. Epub 2011 Sep 8.
This study aimed to evaluate changes over time in the characteristics of permanent hearing impairment (HI) in extremely low-birthweight (ELBW ≤800 g) children.
Data from sequential visits up to 5 years of age assessing hearing and other neurodevelopmental outcomes were extracted from a cohort of ELBW subjects born between 1983 and 2006 at a single Canadian site. Trends in HI incidence, severity and association with other impairments were analysed in three 8-year epochs.
Fifty of 586 ELBW children had a HI. HI rates increased from 5% in epoch 1 to 7% in epoch 2-13% in epoch 3 (p = 0.01). Mild HI decreased from 78% in epoch 1 to 35% in epoch 3 (p = 0.03). Median age at diagnosis decreased from 13 to 8 months. Comorbidities were more common in HI children than non-HI children: cerebral palsy (40% vs 14%, p < 0.0001)), cognitive (38% vs 12%, p < 0.0001) and visual impairments (16% vs 6%, p = 0.009).
The incidence and severity of hearing impairment in a cohort of extremely low-birthweight children increased significantly from 5% to 13% (p = 0.01) over a 24-year period. Comorbidities were common. Potentially modifiable causes are explored.
本研究旨在评估极低出生体重儿（ELBW≤800g）永久性听力损伤（HI）特征随时间的变化。
从 1983 年至 2006 年在加拿大单一地点出生的 ELBW 受试者队列中提取了连续就诊至 5 岁时评估听力和其他神经发育结局的数据。在三个 8 年的时期内分析 HI 发生率、严重程度及其与其他损伤的关系。
586 名 ELBW 儿童中有 50 名患有 HI。HI 发生率从第 1 个时期的 5%增加到第 2-3 个时期的 7%-13%（p=0.01）。轻度 HI 从第 1 个时期的 78%下降到第 3 个时期的 35%（p=0.03）。诊断时的中位年龄从 13 个月降至 8 个月。HI 儿童比非 HI 儿童更常见合并症：脑瘫（40%比 14%，p<0.0001）、认知障碍（38%比 12%，p<0.0001）和视觉障碍（16%比 6%，p=0.009）。
在 24 年期间，极低出生体重儿队列中听力损伤的发生率和严重程度从 5%显著增加到 13%（p=0.01）。合并症很常见。探讨了潜在可改变的病因。
