Pettigrew A G, Edwards D A, Henderson-Smart D J
Department of Physiology, University of Sydney, NSW.
Med J Aust. 1988 Feb 15;148(4):174-7.
The perinatal histories of 16 preterm infants with confirmed moderate-to-profound hearing loss were examined to determine the perinatal factors that might have been associated with their abnormal auditory development. Of the 11 factors that were examined, eight factors occurred significantly more frequently in hearing-impaired infants when they were compared with 226 preterm infants who were cared for in the same intensive care unit in 1984. However, when the histories of the 16 infants with hearing loss were compared with those of 16 infants with normal hearing, who were matched according to gestational age, birthweight percentile and sex, there were no differences. The prevalence of aminoglycoside therapy was high in both groups of infants, but the mean duration of therapy in the infants with a hearing deficit was significantly longer (15 days compared with eight days; P less than 0.025). These observations suggest that younger, smaller, preterm infants with a complicated perinatal course and prolonged aminoglycoside therapy are at higher risk of auditory handicap. We recommend that the early identification of preterm infants with a hearing deficit should be achieved by recording brainstem auditory-evoked responses just before discharge from the intensive care unit.
对16例确诊为中度至重度听力损失的早产儿的围产期病史进行了检查，以确定可能与其听觉发育异常相关的围产期因素。在检查的11个因素中，与1984年在同一重症监护病房接受护理的226例早产儿相比，8个因素在听力受损婴儿中出现的频率明显更高。然而，当将16例听力损失婴儿的病史与16例根据胎龄、出生体重百分位数和性别匹配的听力正常婴儿的病史进行比较时，没有发现差异。两组婴儿中氨基糖苷类药物治疗的发生率都很高，但听力缺陷婴儿的平均治疗持续时间明显更长（15天比8天；P小于0.025）。这些观察结果表明，围产期过程复杂且氨基糖苷类药物治疗时间延长的较小的早产儿发生听觉障碍的风险更高。我们建议，应通过在重症监护病房出院前记录脑干听觉诱发电位来尽早识别有听力缺陷的早产儿。
