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正常出生和极早产新生儿听觉系统的成熟度。

Maturation of the auditory system in normal-hearing newborns with a very or extremely premature birth.

机构信息

Department of Child Health, The Netherlands Organization for Applied Scientific Research TNO, Leiden, the Netherlands.

Department of Neonatology, Isala Clinics, Zwolle, the Netherlands.

出版信息

Pediatr Neonatol. 2020 Oct;61(5):529-533. doi: 10.1016/j.pedneo.2020.05.014. Epub 2020 Jun 12.

Abstract

BACKGROUND

Literature shows that lower gestational age leads to greater delays in the auditory conduction, which suggests atypical maturation of the brainstem in normal-hearing premature newborns. Our aim is to investigate if there is a difference between the extrauterine and intrauterine maturation of the auditory system in normal-hearing newborns with a very premature (28-31 weeks) or extremely premature (<28 weeks) birth.

METHODS

Results of the Automated Auditory Brainstem Response Newborn Hearing Screening Program in Dutch Neonatal Intensive Care Units and diagnostic examinations were centrally registered from 1998 to 2016. Normal-hearing newborns with a gestational age of 25-31 weeks were included. Screening results at 32-45 weeks of postmenstrual age were compared between newborns born with different gestational ages. Multiple imputation was used to predict missing screening results. Small for gestational age was defined as birth weight corrected for gestational age < -1.6 standard deviation. Descriptive and (pooled) logistic regression analyses were performed.

RESULTS

23,964 newborns with 28,754 screening results were eligible. At the same postmenstrual age, pass rates were lower when gestational age was lower in normal-hearing newborns with a very and extremely preterm birth. Pass rates of 80% could be obtained at 34-35, 32-33, and 30-32 weeks' postmenstrual age in newborns with 25, 26-27, 28-31 weeks gestational age, respectively. Small for gestational age had an additional negative effect on pass rates.

CONCLUSION

Analysis of hearing screening data suggests that extrauterine maturation of the auditory system is delayed in normal-hearing newborns with a very or extremely premature birth.

摘要

背景

文献表明,较低的胎龄会导致听觉传导延迟,这表明正常听力早产儿的脑干成熟过程不典型。我们的目的是研究在极早产(28-31 周)或超早产(<28 周)出生的正常听力新生儿中,其宫外和宫内听觉系统的成熟是否存在差异。

方法

1998 年至 2016 年,从荷兰新生儿重症监护病房的自动听觉脑干反应新生儿听力筛查计划和诊断检查中集中登记了结果。纳入胎龄为 25-31 周的正常听力新生儿。比较了不同胎龄新生儿在出生后 32-45 周的筛查结果。使用多元插补法预测缺失的筛查结果。小于胎龄儿定义为出生体重校正胎龄小于-1.6 个标准差。进行描述性和(合并)逻辑回归分析。

结果

23964 名新生儿,28754 次筛查结果符合条件。在正常听力的极早产和超早产儿中,当胎龄较小时,同一胎龄的通过率较低。在胎龄为 25 周、26-27 周、28-31 周的新生儿中,分别可在 34-35 周、32-33 周和 30-32 周的校正胎龄获得 80%的通过率。小于胎龄儿对通过率有额外的负面影响。

结论

听力筛查数据分析表明,在极早产或超早产的正常听力新生儿中,宫外听觉系统的成熟过程延迟。

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