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极低出生体重儿的听力损失及危险因素

Hearing Loss and Risk Factors in Very Low Birth Weight Infants.

作者信息

Frezza Simonetta, Tiberi Eloisa, Corsello Mirta, Priolo Francesca, Cota Francesco, Catenazzi Piero, Conti Guido, Costa Simonetta, Vento Giovanni

机构信息

Department of Woman and Child Health and Public Health, Catholic University of Sacred Heart, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy.

Neonatal Intensive Care Unit, Maggiore Hospital, 40133 Bologna, Italy.

出版信息

J Clin Med. 2023 Dec 8;12(24):7583. doi: 10.3390/jcm12247583.

Abstract

The incidence of sensorineural hearing loss (SNHL) is still high in very low birth weight (VLBW) infants. The purpose of our study was to provide the prevalence rates of SNHL and to analyze the risk factors of hearing impairment and changes in hearing thresholds in a cohort of VLBW infants. A retrospective observational study was conducted in our neonatal intensive care unit (NICU) from 2012 to 2016. All VLBW infants included were screened by transient evoked otoacoustic emissions (TEOAEs) and diagnostic auditory brainstem response (ABR). In total, we enrolled 316 infants and SNHL was diagnosed in 68, leading to an early incidence of 21.5% as 36 infants out of 68 improved. Finally, SNHL was confirmed in 20 patients (6.3%) who needed hearing aids. They were significantly smaller, sicker, had longer hospitalizations, and received more ototoxic therapies. Logistic regression analysis showed that gestational age (GA) influenced the association between drugs and SNHL. The results underlined how the total exposure to antibiotics is significantly associated with SNHL, even after GA correction. In conclusion, GA, birth weight and, above all, the length and complexity of NICU stay quantify the risk of SNHL and should be considered at the individual level for parent counseling.

摘要

极低出生体重(VLBW)婴儿中感音神经性听力损失(SNHL)的发生率仍然很高。我们研究的目的是提供SNHL的患病率,并分析一组VLBW婴儿听力障碍的危险因素以及听力阈值的变化。2012年至2016年在我们的新生儿重症监护病房(NICU)进行了一项回顾性观察研究。纳入的所有VLBW婴儿均通过瞬态诱发耳声发射(TEOAEs)和诊断性听性脑干反应(ABR)进行筛查。我们总共纳入了316名婴儿,其中确诊为SNHL的有68名,由于68名中有36名婴儿听力有所改善,因此早期发病率为21.5%。最终,有20名患者(6.3%)被确诊为SNHL并需要佩戴助听器。他们明显更小、病情更重、住院时间更长,且接受了更多耳毒性治疗。逻辑回归分析表明,胎龄(GA)影响药物与SNHL之间的关联。结果强调,即使在校正GA后,抗生素的总暴露量仍与SNHL显著相关。总之,GA、出生体重,尤其是NICU住院时间的长短和复杂性可量化SNHL的风险,在为家长提供咨询时应在个体层面予以考虑。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7126/10744215/714829bc36b7/jcm-12-07583-g001.jpg

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