Department of Pediatrics, First Hospital of Hebei Medical University, Hebei Medical University, Shijiazhuang, 050000, China.
Department of Pediatrics, Zhengding People's Hospital, Shijiazhuang, 050000, China.
Eur J Pediatr. 2024 May;183(5):2401-2409. doi: 10.1007/s00431-024-05498-3. Epub 2024 Mar 8.
Hearing loss is a common disability in infants that significantly impacts their cognitive, language, and literacy development. This study aimed to systematically assess the risk factors for the early identification and intervention in infant hearing loss. Databases were searched for meta-analyses of observational studies until November 2023. The quality assessment was performed using the Cochrane risk of bias tool, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to assess the certainty of the evidence. A meta-analysis identified 14 risk factors significantly associated with infant hearing loss. According to the GRADE approach, there were four factors with moderate-certainty evidence (low birth weight(LBW), congenital anomalies, craniofacial anomalies, intracranial hemorrhages), seven factors with low-certainty evidence (ototoxic medications, family history of hearing loss, mechanical ventilation > 5 days, intrauterine infection, admission to neonatal intensive care unit (NICU) > 5 days, mechanical ventilation and asphyxia) and six with extremely-low-certainty evidence (very low birth weight < 1500 g (VLBW), hyperbilirubinemia, sepsis or meningitis, male sex, premature birth, small for gestational age (SGA)). Nevertheless, no significant association was found between infant hearing loss and factors such as small for gestational age (SGA), male sex, and premature birth (P > 0.05). Conclusion: The identification of these 14 interrelated risk factors can prove advantageous in clinical practice, as these findings could guide hearing screening and parental counseling. Furthermore, prospective research could be conducted to develop risk-based scoring systems based on these factors. What is Known: • Infant hearing loss is a worldwide issue. • Risk factors for this condition are debated. What is New: • This is the first meta-analysis to comprehensively evaluate perinatal and postnatal risk factors for hearing loss in infants. • Intracranial hemorrhage, mechanical ventilation, and low birth weight are associated with infant hearing loss. However, no evidence of an association was found between premature birth, being small for gestational age, or male sex and hearing loss.
听力损失是婴儿常见的残疾，会严重影响他们的认知、语言和读写能力发展。本研究旨在系统评估婴儿听力损失的早期识别和干预的风险因素。直到 2023 年 11 月，对观察性研究的荟萃分析进行了数据库检索。使用 Cochrane 偏倚风险工具进行质量评估，并使用推荐评估、制定与评价（GRADE）方法评估证据的确定性。荟萃分析确定了 14 个与婴儿听力损失显著相关的风险因素。根据 GRADE 方法，有 4 个因素具有中等确定性证据（低出生体重（LBW）、先天性异常、颅面异常、颅内出血），7 个因素具有低确定性证据（耳毒性药物、听力损失家族史、机械通气>5 天、宫内感染、新生儿重症监护病房（NICU）入住>5 天、机械通气和窒息），6 个因素具有极低确定性证据（极低出生体重<1500 克（VLBW）、高胆红素血症、败血症或脑膜炎、男性、早产、小于胎龄儿（SGA））。然而，婴儿听力损失与小胎龄儿（SGA）、男性和早产等因素之间没有显著关联（P>0.05）。结论：识别这 14 个相互关联的风险因素在临床实践中可能是有利的，因为这些发现可以指导听力筛查和家长咨询。此外，可以进行前瞻性研究，基于这些因素开发基于风险的评分系统。已知内容：•婴儿听力损失是一个全球性问题。•该病症的风险因素存在争议。新内容：•这是第一次全面评估婴儿围产期和产后听力损失的风险因素的荟萃分析。•颅内出血、机械通气和低出生体重与婴儿听力损失相关。然而，没有证据表明早产、小于胎龄或男性与听力损失有关。
