Poonual Watcharapol, Navacharoen Niramon, Kangsanarak Jaran, Namwongprom Sirianong
Clinical Epidemiology Program, Chiang Mai University, Chiang Mai, Thailand.
Department of Otolaryngology, Chiang Mai University, Chiang Mai, Thailand.
J Multidiscip Healthc. 2015 Dec 24;9:1-5. doi: 10.2147/JMDH.S92818. eCollection 2016.
To define the risk factors for hearing loss in infants (aged 3 months) under universal hearing screening program.
A total of 3,120 infants (aged 3 months) who underwent hearing screening using a universal hearing screening program using automated otoacoustic emission test between November 1, 2010 and May 31, 2012 in Uttaradit Hospital, Buddhachinaraj Hospital, and Sawanpracharuk Hospital (tertiary hospitals) located in Northern Thailand were included in this prospective cohort study.
Of the 3,120 infants, 135 (4.3%) were confirmed to have hearing loss with the conventional otoacoustic emission test. Five of these 135 infants (3.7%) with hearing loss showed test results consistent with auditory brainstem responses. From the univariable analysis, there were eleven potential risk factors associated with hearing deterioration. On multivariable analysis, the risk factors independently associated with hearing loss at 3 months were birth weight 1,500-2,500 g (risk ratio [RR] 1.6, 95% confidence interval [CI] 1.1-2.6), APGAR score <6 at 5 minutes (RR 2.2, 95% CI 1.1-4.4), craniofacial anomalies (RR 2.5, 95% CI 1.6-4.2), sepsis (RR 1.8, 95% CI 1.0-3.2), and ototoxic exposure (RR 4.1, 95% CI 1.9-8.6).
This study concluded that low birth weight, APGAR score <6 at 5 minutes, craniofacial anomalies, sepsis, and ototoxic exposure are the risk factors for bilateral hearing loss in infants (aged 3 months) and proper tests should be performed to identify these risk factors. As an outcome, under the present circumstances, it is suggested that infirmary/physicians/general practitioners/health action centers/polyclinics should carry out universal hearing screening in all infants before 36 weeks. The public health policy of Thailand regarding a universal hearing screening program is important for the prevention of disability and to enhance people's quality of life.
确定在普遍听力筛查项目下3个月大婴儿听力损失的风险因素。
2010年11月1日至2012年5月31日期间，在泰国北部的乌塔拉迪医院、布达恰纳拉杰医院和萨旺普拉查鲁克医院（三级医院），共有3120名3个月大的婴儿接受了使用自动耳声发射测试的普遍听力筛查项目，该前瞻性队列研究纳入了这些婴儿。
在这3120名婴儿中，135名（4.3%）通过传统耳声发射测试确诊有听力损失。这135名听力损失婴儿中有5名（3.7%）的测试结果与听性脑干反应一致。单变量分析显示，有11个潜在风险因素与听力恶化有关。多变量分析显示，与3个月大时听力损失独立相关的风险因素为出生体重1500 - 2500克（风险比[RR] 1.6，95%置信区间[CI] 1.1 - 2.6）、5分钟时阿氏评分<6（RR 2.2，95% CI 1.1 - 4.4）、颅面畸形（RR 2.5，95% CI 1.6 - 4.2）、败血症（RR 1.8，95% CI 1.0 - 3.2）和耳毒性暴露（RR 4.1，95% CI 1.9 - 8.6）。
本研究得出结论，低出生体重、5分钟时阿氏评分<6、颅面畸形、败血症和耳毒性暴露是3个月大婴儿双侧听力损失的风险因素，应进行适当测试以识别这些风险因素。因此，在当前情况下，建议医务室/医生/全科医生/健康行动中心/多专科门诊应在所有婴儿36周前进行普遍听力筛查。泰国关于普遍听力筛查项目的公共卫生政策对于预防残疾和提高人们的生活质量很重要。
