Xiao Tiejun, Li Yuru, Xiao Lifeng, Jiang Li, Hu Qi
ENT, First Affiliated Hospital of Harbin Medical University, Harbin 150000, Heilongjiang, China.
ENT, First Affiliated Hospital of Harbin Medical University, Harbin 150000, Heilongjiang, China.
Int J Pediatr Otorhinolaryngol. 2015 Apr;79(4):516-9. doi: 10.1016/j.ijporl.2015.01.019. Epub 2015 Jan 28.
Infants born by cesarean delivery (CD) appear to fail the otoacoustic emission (OAE) test more frequently than infants delivered vaginally (VD).
The present study aimed to evaluate the influence of CD on failure to the OAE test in Chinese infants.
In this retrospective study, 1460 Chinese infants were included. The OAE test was performed before hospital discharge. Modes of delivery, test time and OAE results were collected and analyzed.
Compared with VD infants, CD infants had lower gestational age (week), were smaller for their gestational age (SGA), and presented a lower 1-min Apgar score and a younger age at first OAE. On multivariate analysis, CD and age at first OAE were significantly associated with failed OAE (both P<0.001). CD infants had a 3-fold higher rate of failure to the OAE test compared with VD infants (21% vs. 7.1%). The results of the OAE test changed with different test time regardless of the mode of delivery, and the neonatal OAE test failure rate decreased with time. The difference was not significant between CD and VD infants 42h or more after delivery.
CD infants had significantly higher failure rates on first OAE test. Results suggest that the OAE test should be performed 42h after delivery so as to minimize repetition of OAE, improve the OAE test pass rate, and minimize costs and parents' anxiety.
剖宫产出生的婴儿似乎比阴道分娩的婴儿更频繁地出现耳声发射（OAE）测试失败。
本研究旨在评估剖宫产对中国婴儿OAE测试失败的影响。
在这项回顾性研究中，纳入了1460名中国婴儿。在出院前进行OAE测试。收集并分析分娩方式、测试时间和OAE结果。
与阴道分娩的婴儿相比，剖宫产的婴儿孕周较低，小于胎龄（SGA），1分钟阿氏评分较低，首次OAE测试时年龄较小。多因素分析显示，剖宫产和首次OAE测试时的年龄与OAE测试失败显著相关（均P<0.001）。剖宫产婴儿的OAE测试失败率是阴道分娩婴儿的3倍（21%对7.1%）。无论分娩方式如何，OAE测试结果随测试时间不同而变化，新生儿OAE测试失败率随时间下降。分娩后42小时或更长时间，剖宫产和阴道分娩婴儿之间的差异不显著。
剖宫产婴儿首次OAE测试的失败率显著更高。结果表明，应在分娩后42小时进行OAE测试，以尽量减少OAE测试的重复，提高OAE测试通过率，并尽量降低成本和减少家长的焦虑。
