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采用两步法方案及危险因素识别的新生儿听力筛查:我们在印度东部一家三级医疗中心的经验。

Newborn Hearing Screening with Two-Step Protocol and Risk Factor Identification: Our Experience at a Tertiary Care Centre in Eastern India.

作者信息

Parida Pradipta Kumar, Veetil Aswathi Kallyadan, Karakkandy Vinusree, Chappity Preetam, Sarkar Saurav, Pradhan Pradeep, Samal Dillip Kumar, Anil Abhishek, Eby Anju Sara

机构信息

Department of ENT and HNS, All India Institute of Medical Sciences, Bhubaneswar, India.

Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur, India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2023 Sep;75(3):1743-1749. doi: 10.1007/s12070-023-03723-3. Epub 2023 Mar 29.

Abstract

OBJECTIVE

To estimate the prevalence of hearing loss and identify the high-risk factors among neonates with hearing loss.

METHODS

Retrospective study done on 1054 infants in a tertiary care centre in Eastern India from 2020 to 2021 and approved by the Institutional Ethics Committee. A two-step protocol is used for screening. In the well-nursed group, OAE and BOA were performed. In the case of REFER results for automated ABR following OAE evaluation in well-nursed babies, a detailed audiological evaluation was scheduled to be carried out using diagnostic ABR within one month of age. In the high-risk group, hearing screening includes OAE, BOA, and AABR evaluations. AABR evaluation was performed as a part of the screening protocol irrespective of the results of OAE screening as PASS or REFER.

RESULTS

In our study among 1053 neonates screened, 375 were in the risk category, and 679 were without risk factors. The overall prevalence of hearing loss in neonates was 22.78 per 1000 screened neonates and 56 per 1000 among high-risk neonates. In the high-risk group, we were able to identify 4 cases of Auditory spectrum neuropathy disorder with the use of AABR during 1st step of screening. In multivariate regression analysis, the risk factors for hearing loss identified were NICU stay (OR = 3.6, 95% CI = 1.1-12.03) and Craniofacial anomalies (OR = 55.37, 95% CI = 16.48- 186.01).

CONCLUSION

Early neonatal screening helps in the detection, intervention, and rehabilitation of hearing loss. The use of AABR in risk infant screening enhanced the chance of detection of auditory spectrum neuropathy disorder (ASND) cases.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s12070-023-03723-3.

摘要

目的

评估听力损失的患病率,并确定听力损失新生儿的高危因素。

方法

对印度东部一家三级护理中心2020年至2021年期间的1054名婴儿进行回顾性研究,并获得机构伦理委员会批准。采用两步筛查方案。在健康护理组中,进行耳声发射(OAE)和脑干听觉诱发电位(BOA)检查。在健康护理婴儿中,若OAE评估后自动听性脑干反应(ABR)结果为“参考”,则计划在婴儿1月龄内使用诊断性ABR进行详细的听力学评估。在高危组中,听力筛查包括OAE、BOA和自动听性脑干反应(AABR)评估。无论OAE筛查结果为“通过”或“参考”,AABR评估均作为筛查方案的一部分进行。

结果

在我们研究的1053名接受筛查的新生儿中,375名属于高危类别,679名无危险因素。新生儿听力损失的总体患病率为每1000名筛查新生儿中22.78例,高危新生儿中每1000名有56例。在高危组中,我们在筛查的第一步使用AABR能够识别出4例听神经病谱系障碍病例。在多因素回归分析中,确定的听力损失危险因素为新生儿重症监护病房(NICU)住院(比值比[OR]=3.6,95%置信区间[CI]=1.1-12.03)和颅面畸形(OR=55.37,95%CI=16.48-186.01)。

结论

早期新生儿筛查有助于听力损失的检测、干预和康复。在高危婴儿筛查中使用AABR提高了检测听神经病谱系障碍(ASND)病例的机会。

补充信息

在线版本包含可在10.1007/s12070-023-03723-3获取的补充材料。

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