Labaeka Adeyemi A, Tongo Olukemi O, Ogunbosi Babatunde O, Fasunla James A
Department of Paediatrics, University College Hospital Ibadan, Ibadan, Nigeria.
Department of Paediatrics, University of Ibadan, Ibadan, Nigeria.
Front Pediatr. 2018 Jul 16;6:194. doi: 10.3389/fped.2018.00194. eCollection 2018.
The burden of severe hearing impairment is increasing with two-thirds of these hearing impaired people residing in developing countries. Newborn hearing screening helps to identify early, babies who need intervention in order to prevent future disability. Neither universal nor targeted hearing screening programme is available in Nigeria. This study was carried out to assess the prevalence of hearing impairment among high-risk newborns in UCH and the associated risk factors. Two hundred one newborns in the neonatal unit of UCH with risk factors for hearing impairment had hearing screening done using automated auditory brainstem response (AABR) at 30, 45, and 70 dB at admission and discharge, and those that failed screening at discharge were rescreened at 6 weeks post-discharge. Eighty-three (41.3%) and 32 (15.9%) high-risk newborns failed at admission and discharge screening respectively, and 19 (9.5%) still failed at follow up screening. The majority of hearing loss at follow up was bilateral (94.7%) and severe (52.6%). The risk factors associated with persistent hearing loss at follow up were acute bilirubin encephalopathy (RR = 11.2, CI: 1.4-90.6), IVH (RR = 8.8, CI: 1.1-71.8), meningitis (RR = 4.8, CI: 1.01-29), recurrent apnoea (RR = 2.7, CI: 1.01-7.3), severe perinatal asphyxia NNE III (RR = 7, CI: 2.4-20.2). Severe and bilateral hearing impairment is a common complication among high risk newborns in UCH persisting till 6 weeks post-neonatal care. Severe perinatal asphyxia with NNE III, ABE, IVH, meningitis and administration of amikacin for more than 5 days were significant risk factors. We recommend that SCBU graduates with these risk factors should have mandatory audiologic evaluation at discharge.
重度听力障碍的负担正在增加，其中三分之二的听力受损者居住在发展中国家。新生儿听力筛查有助于早期识别需要干预的婴儿，以防止未来出现残疾。尼日利亚既没有普及的也没有针对性的听力筛查项目。本研究旨在评估UCH高危新生儿中听力障碍的患病率及相关危险因素。UCH新生儿病房中201名有听力障碍危险因素的新生儿在入院和出院时分别使用自动听性脑干反应（AABR）在30、45和70分贝进行听力筛查，出院时筛查未通过的新生儿在出院后6周进行复查。分别有83名（41.3%）和32名（15.9%）高危新生儿在入院和出院筛查时未通过，19名（9.5%）在复查时仍未通过。复查时大多数听力损失为双侧（94.7%）且为重度（52.6%）。与复查时持续性听力损失相关的危险因素有急性胆红素脑病（RR = 11.2，CI：1.4 - 90.6）、脑室内出血（RR = 8.8，CI：1.1 - 71.8）、脑膜炎（RR = 4.8，CI：1.01 - 29））、反复呼吸暂停（RR = 2.7，CI：1.01 - 7.3）、重度围产期窒息NNE III（RR = 7，CI：2.4 - 20.2）。重度和双侧听力障碍是UCH高危新生儿中常见的并发症，一直持续到新生儿护理后6周。重度围产期窒息伴NNE III、ABE、IVH、脑膜炎以及使用阿米卡星超过5天是重要的危险因素。我们建议有这些危险因素的SCBU毕业生在出院时应进行强制性听力评估。
