Sequi-Canet José M, Sala-Langa María J, Collar Del Castillo José I
Servicio de Pediatría, Hospital Francesc de Borja, Gandía, Valencia, España.
Servicio de Pediatría, Hospital Francesc de Borja, Gandía, Valencia, España.
Acta Otorrinolaringol Esp. 2014 Jan-Feb;65(1):1-7. doi: 10.1016/j.otorri.2013.07.007. Epub 2013 Sep 27.
Most hospitals perform neonatal hearing screening because it is a very useful procedure. Otoacoustic emissions are an ideal technique for this screening. We analyse the possible influence on screening results of some perinatal factors.
We collected retrospective data from 8,239 healthy newborns delivered vaginally at the maternity ward of our hospital. We compared multiple perinatal factors vs the results of otoacoustic emissions performed within the first 48 h of life, before discharge.
A total of 6.4% of newborns had an abnormal response and failed the screening. Univariate and multivariate analysis showed a significant (P<.0001) positive relationship between breastfeeding and normal otoacoustic emissions (OR: 0.65). Another, less significant factor was female gender. The remaining variables, including origin, education or employment status of the mother, maternal smoking, dystocic delivery, presentation, need for resuscitation, preterm labour (34-36 weeks), weight, length and frequent maternal pathology, such as streptococcus detection, hypothyroidism, hypertension or diabetes, were not significant.
Breastfeeding was the most important factor related to a normal response in otoacoustic emissions. It may improve final results and reduce the number of neonates who need to be rescheduled for a repeated test, as well as the associated anxiety and the possibility of losing patients during follow-up. These are major problems in neonatal hearing screening.
大多数医院都开展新生儿听力筛查,因为这是一项非常有用的检查。耳声发射是进行此项筛查的理想技术。我们分析了一些围产期因素对筛查结果可能产生的影响。
我们收集了我院产科病房8239例经阴道分娩的健康新生儿的回顾性数据。我们比较了多种围产期因素与出生后48小时内、出院前进行的耳声发射检查结果。
共有6.4%的新生儿反应异常,筛查未通过。单因素和多因素分析显示,母乳喂养与正常耳声发射之间存在显著的(P<0.0001)正相关关系(比值比:0.65)。另一个不太显著的因素是女性性别。其余变量,包括母亲的籍贯、教育程度或就业状况、母亲吸烟、难产、胎位、复苏需求、早产(34 - 36周)、体重、身长以及母亲常见疾病,如链球菌检测、甲状腺功能减退、高血压或糖尿病等,均无显著意义。
母乳喂养是与耳声发射正常反应相关的最重要因素。它可能改善最终结果,减少需要重新安排进行复查的新生儿数量,以及相关的焦虑情绪和随访期间失去患者的可能性。这些都是新生儿听力筛查中的主要问题。