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德国高危新生儿听力损失的患病率及危险因素。

Prevalence and risk factors for hearing loss in high-risk neonates in Germany.

机构信息

Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Marburg, University of Gießen and Marburg, Marburg, Germany.

Department of International Health, CAPHRI - Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands.

出版信息

Acta Paediatr. 2019 Nov;108(11):1972-1977. doi: 10.1111/apa.14837. Epub 2019 Jun 2.

Abstract

AIM

Hearing loss in infants is often diagnosed late, despite universal screening programmes. Risk factors of hearing impairment in high-risk neonates, identified from population-based studies, can inform policy around targeted screening. Our aim was to determine the prevalence and the risk factors of hearing loss in a high-risk neonatal population.

METHODS

This was a retrospective cohort study of neonates hospitalised at the University Hospital Cologne, Germany from January 2009 to December 2014 and were part of the newborn hearing screening programme. Multivariable regression analyses using the lasso approach was performed.

RESULTS

Data were available for 4512 (43% female) neonates with a mean gestational age at birth of 35.5 weeks. The prevalence of hearing loss was 1.6%, and 42 (0.9%) neonates had permanent hearing loss. Craniofacial anomalies, hyperbilirubinaemia requiring exchange transfusion, oxygen supplementation after 36 weeks of gestation and hydrops fetalis showed associations with permanent hearing loss.

CONCLUSION

Our findings of risk factors for hearing loss were consistent with other studies. However, some commonly demonstrated risk factors such as perinatal infections, meningitis, sepsis and ototoxic drugs did not show significant associations in our cohort. Targeted screening based on risk factors may help early identification of hearing loss in neonates.

摘要

目的

尽管普遍开展了筛查项目,但婴儿听力损失仍常常被漏诊。基于人群的研究确定了高危新生儿听力障碍的危险因素,这些危险因素可为有针对性的筛查政策提供信息。我们的目的是确定高危新生儿人群中听力损失的患病率和危险因素。

方法

这是一项回顾性队列研究,纳入了 2009 年 1 月至 2014 年 12 月在德国科隆大学医院住院的高危新生儿,并纳入了新生儿听力筛查计划。使用套索法进行多变量回归分析。

结果

共有 4512 名(43%为女性)新生儿的数据可用,其出生时的平均胎龄为 35.5 周。听力损失的患病率为 1.6%,42 名(0.9%)新生儿有永久性听力损失。颅面畸形、需要换血的高胆红素血症、36 周后吸氧和胎儿水肿与永久性听力损失有关。

结论

我们发现的听力损失危险因素与其他研究一致。然而,我们的队列中一些常见的危险因素,如围产期感染、脑膜炎、败血症和耳毒性药物,并没有显示出显著的关联。基于危险因素的有针对性的筛查可能有助于早期发现新生儿的听力损失。

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