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早产新生儿听力障碍——基于波兰国家听力筛查数据库的分析

Hearing impairment in premature newborns-Analysis based on the national hearing screening database in Poland.

作者信息

Wroblewska-Seniuk Katarzyna, Greczka Grazyna, Dabrowski Piotr, Szyfter-Harris Joanna, Mazela Jan

机构信息

Department of Newborns' Infectious Diseases, Poznan University of Medical Sciences, Poznan, Poland.

Department of Otolaryngology and Oncological Laryngology, Poznan University of Medical Sciences, Poznan, Poland.

出版信息

PLoS One. 2017 Sep 14;12(9):e0184359. doi: 10.1371/journal.pone.0184359. eCollection 2017.

Abstract

OBJECTIVES

The incidence of sensorineural hearing loss is between 1 and 3 per 1000 in healthy neonates and 2-4 per 100 in high-risk infants. The national universal neonatal hearing screening carried out in Poland since 2002 enables selection of infants with suspicion and/or risk factors of hearing loss. In this study, we assessed the incidence and risk factors of hearing impairment in infants ≤33 weeks' gestational age (wga).

METHODS

We analyzed the database of the Polish Universal Newborns Hearing Screening Program from 2010 to 2013. The study group involved 11438 infants born before 33 wga, the control group-1487730 infants. Screening was performed by means of transient evoked otoacoustic emissions. The risk factors of hearing loss were recorded. Infants who failed the screening test and/or had risk factors were referred for further audiological evaluation.

RESULTS

Hearing deficit was diagnosed in 11% of infants ≤25 wga, 5% at 26-27 wga, 3.46% at 28 wga and 2-3% at 29-32 wga. In the control group the incidence of hearing deficit was 0.2% (2.87% with risk factors). The most important risk factors were craniofacial malformations, very low birth weight, low Apgar score and mechanical ventilation. Hearing screening was positive in 22.42% newborns ≤28 wga and 10% at 29-32 wga and in the control group.

CONCLUSIONS

Hearing impairment is a severe consequence of prematurity. Its prevalence is inversely related to the maturity of the baby. Premature infants have many concomitant risk factors which influence the occurrence of hearing deficit.

摘要

目的

健康新生儿感音神经性听力损失的发生率为每1000例中有1至3例,高危婴儿中则为每100例中有2至4例。波兰自2002年起开展的全国新生儿听力普遍筛查,能够筛出有听力损失可疑和/或危险因素的婴儿。在本研究中,我们评估了孕周≤33周(wga)婴儿听力障碍的发生率及危险因素。

方法

我们分析了2010年至2013年波兰新生儿听力普遍筛查项目的数据库。研究组包括11438例孕周小于33周出生的婴儿,对照组为1487730例婴儿。筛查采用瞬态诱发耳声发射进行。记录听力损失的危险因素。筛查试验未通过和/或有危险因素的婴儿被转诊进行进一步的听力学评估。

结果

孕周≤25周的婴儿中,11%被诊断为听力缺陷;26至27周时为5%;28周时为3.46%;29至32周时为2%至3%。对照组中听力缺陷的发生率为0.2%(有危险因素的为2.87%)。最重要的危险因素是颅面畸形、极低出生体重、低阿氏评分和机械通气。孕周≤28周的新生儿中,22.42%听力筛查呈阳性;29至32周时为10%,对照组情况相同。

结论

听力障碍是早产的严重后果。其患病率与婴儿成熟度呈负相关。早产儿有许多伴随的危险因素,这些因素会影响听力缺陷的发生。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b94/5598959/4f219da988ec/pone.0184359.g001.jpg

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