Huang Lili, Xiong Fei, Li Jinrong, Yang Fan
Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, 610041, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, China.
Int J Pediatr Otorhinolaryngol. 2017 Apr;95:15-19. doi: 10.1016/j.ijporl.2017.01.027. Epub 2017 Jan 27.
The aim of this study was to analyze the hearing screening program among preterm infants as well as to identify risk factors associated with failing primary newborn hearing screening.
The retrospectively selected population included all preterm infants who had primary hearing screening in a neonatal ward from January 1st, 2013 to December 31st, 2015 at West China Second University Hospital, Sichuan University. The newborn hearing screening (NHS) procedure was performed in all preterm infants by automated auditory brainstem response (AABR). Infants who failed the primary hearing screening received a second screening at 42 days after birth. Infants who failed both tests were referred to a tertiary audiology center for diagnostic confirmation and management before 6 months of age. The final diagnosis for referred infants was obtained by telephone follow-up. The risk factors associated with failure to pass the primary hearing screen were evaluated and analyzed for preterm infants.
Among 2291 preterm infants recruited, 155 infants (6.8%) failed the primary hearing screening with an abnormal AABR. Of these 155 infants, 113 (72.9%) passed the secondary screening. At the end of the follow-up, 1 infant (0.04%) was diagnosed with hearing loss, 3 infants had delayed language development, and 40 infants were lost to follow up. Multivariate regression analysis revealed that gestational age ≤32 weeks (Odds ratio [OR] = 2.093, 95% confidence interval [CI] 1.370-3.196), super hyperbilirubinemia (≥25 mg/dl) (OR = 3.560, 95% CI 1.009-12.560), and respiratory failure (OR = 1.971, 95% CI 1.188-3.265) were associated with failure to pass newborn hearing screening.
The prevalence of failure to pass primary hearing screening among preterm infants was 6.8% in our study, and we found a relatively low prevalence of hearing loss (0.04%). Super hyperbilirubinemia, gestational age ≤32weeks, and respiratory failure were risk factors associated with failure of preterm infants to pass the primary hearing screening. Our results suggest that preterm infants with hyperbilirubinemia, gestational age ≤32 weeks, and respiratory failure should be closely followed.
本研究旨在分析早产儿听力筛查项目,并确定与新生儿听力初筛未通过相关的风险因素。
回顾性选取2013年1月1日至2015年12月31日在四川大学华西第二医院新生儿病房接受听力初筛的所有早产儿。所有早产儿均采用自动听性脑干反应(AABR)进行新生儿听力筛查(NHS)。听力初筛未通过的婴儿在出生后42天接受第二次筛查。两次筛查均未通过的婴儿在6个月龄前被转诊至三级听力中心进行诊断确认和治疗。通过电话随访获得转诊婴儿的最终诊断结果。对早产儿中与听力初筛未通过相关的风险因素进行评估和分析。
在纳入的2291例早产儿中,155例(6.8%)听力初筛未通过,AABR异常。在这155例婴儿中,113例(72.9%)通过了二次筛查。随访结束时,1例(0.04%)被诊断为听力损失,3例语言发育迟缓,40例失访。多因素回归分析显示,胎龄≤32周(比值比[OR]=2.093,95%置信区间[CI]1.370 - 3.196)、超高胆红素血症(≥25mg/dl)(OR = 3.560,95%CI 1.009 - 12.560)和呼吸衰竭(OR = 1.971,95%CI 1.188 - 3.265)与新生儿听力筛查未通过相关。
本研究中早产儿听力初筛未通过的发生率为6.8%,听力损失发生率相对较低(0.04%)。超高胆红素血症、胎龄≤32周和呼吸衰竭是与早产儿听力初筛未通过相关的风险因素。我们的结果表明,应密切随访患有高胆红素血症、胎龄≤32周和呼吸衰竭的早产儿。