Pineda Roberta, Durant Polly, Mathur Amit, Inder Terrie, Wallendorf Michael, Schlaggar Bradley L
Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO; Department of Pediatrics, Washington University School of Medicine, St. Louis, MO.
Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO.
J Pediatr. 2017 Apr;183:56-66.e3. doi: 10.1016/j.jpeds.2016.12.072. Epub 2017 Feb 8.
To quantify early auditory exposures in the neonatal intensive care unit (NICU) and evaluate how these are related to medical and environmental factors. We hypothesized that there would be less auditory exposure in the NICU private room, compared with the open ward.
Preterm infants born at ≤ 28 weeks gestation (33 in the open ward, 25 in private rooms) had auditory exposure quantified at birth, 30 and 34 weeks postmenstrual age (PMA), and term equivalent age using the Language Environmental Acquisition device.
Meaningful language (P < .0001), the number of adult words (P < .0001), and electronic noise (P < .0001) increased across PMA. Silence increased (P = .0007) and noise decreased (P < .0001) across PMA. There was more silence in the private room (P = .02) than the open ward, with an average of 1.9 hours more silence in a 16-hour period. There was an interaction between PMA and room type for distant words (P = .01) and average decibels (P = .04), indicating that changes in auditory exposure across PMA were different for infants in private rooms compared with infants in the open ward. Medical interventions were related to more noise in the environment, although parent presence (P = .009) and engagement (P = .002) were related to greater language exposure. Average sound levels in the NICU were 58.9 ± 3.6 decibels, with an average peak level of 86.9 ± 1.4 decibels.
Understanding the NICU auditory environment paves the way for interventions that reduce high levels of adverse sound and enhance positive forms of auditory exposure, such as language.
量化新生儿重症监护病房（NICU）内的早期听觉暴露情况，并评估其与医疗和环境因素的关系。我们假设，与开放式病房相比，NICU单人病房的听觉暴露会更少。
对孕周≤28周的早产儿（33例在开放式病房，25例在单人病房）在出生时、出生后30周和34周的月经龄（PMA）以及足月等效年龄时，使用语言环境采集设备对听觉暴露进行量化。
有意义的语言（P＜0.0001）、成人词汇数量（P＜0.0001）和电子噪音（P＜0.0001）随PMA增加。安静时间增加（P = 0.0007），噪音随PMA减少（P＜0.0001）。单人病房的安静时间比开放式病房更多（P = 0.02），在16小时内平均多1.9小时的安静时间。对于远距离词汇（P = 0.01）和平均分贝（P = 0.04），PMA与病房类型之间存在交互作用，表明与开放式病房的婴儿相比，单人病房婴儿在PMA期间听觉暴露的变化有所不同。医疗干预与环境中更多的噪音有关，尽管父母在场（P = 0.009）和参与（P = 0.002）与更多的语言暴露有关。NICU的平均声级为58.9±3.6分贝，平均峰值声级为86.9±1.4分贝。
了解NICU的听觉环境为减少高水平不良声音并增强积极的听觉暴露形式（如语言）的干预措施铺平了道路。
