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对于高危新生儿的听力筛查方案的定义，应如何考虑高胆红素血症？

How should hyperbilirubinemia be considered in the definition of the hearing screening protocol for neonates at risk?

机构信息

Faculdade de Odontologia de Bauru - FOB, Universidade de São Paulo - USP - Bauru (SP), Brasil.

Programa de Residência Médica em Otorrinolaringologia, Instituto Penido Burnier - IPB - Campinas (SP), Brasil.

出版信息

Codas. 2024 Mar 11;36(2):e20220273. doi: 10.1590/2317-1782/20232022273pt. eCollection 2024.

DOI:10.1590/2317-1782/20232022273pt
PMID:38477758
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10939397/
Abstract

PURPOSE

To analyze hyperbilirubinemia as an indicator for the definition of risk protocol in newborn hearing screening (NHS) and in auditory monitoring in full-term and preterm neonates.

METHODS

This is an observational, cross-sectional and retrospective study. A total of 554 children born in a public maternity hospital were included and divided into two groups: (G1) with 373 full-terms neonates; (G2) with 181 preterm neonates. Data were collected from the participant's medical records to obtain information regarding the result of the NHS, performed by recording the automated auditory brainstem response (AABR), birth conditions, clinical characteristics, interventions performed, and results of the first test of total bilirubin (TB) and indirect bilirubin (IB) as well as the peak of TB and IB. A descriptive statistical analysis of the results was performed, and the level of significance adopted was 5%.

RESULTS

On the NHS test, quotes of retest referral rates were smaller in G1 when compared to G2. There was no significant difference between the groups regarding type of delivery, gender, presence of Rh and ABO incompatibility, G6PD enzyme deficiency, and performance of phototherapy. TB and IB levels at the first exam and at peak time did not differ between neonates with "pass" and "fail" results on the NHS test in both groups.

CONCLUSION

Bilirubin levels in the neonatal period below the recommended values for indication of exchange transfusion are not directly related to the "fail" result on the NHS tests in term and preterm neonates.

摘要

目的

分析高胆红素血症作为新生儿听力筛查（NHS）和足月及早产儿听觉监测风险方案定义的指标。

方法

这是一项观察性、横断面和回顾性研究。共纳入 554 名在公立妇产医院出生的儿童，分为两组：（G1）组 373 名足月新生儿；（G2）组 181 名早产儿。从参与者的病历中收集数据，以获得 NHS 结果的信息，通过记录自动听性脑干反应（AABR）进行，收集出生情况、临床特征、干预措施以及总胆红素（TB）和间接胆红素（IB）的首次检测结果和 TB 和 IB 的峰值。对结果进行描述性统计分析，采用 5%的显著性水平。

结果

在 NHS 测试中，G1 组的重测转诊率明显低于 G2 组。两组在分娩方式、性别、Rh 和 ABO 不相容、G6PD 酶缺乏以及光疗方面无显著差异。两组 NHS 测试结果“通过”和“失败”的新生儿，其首次检查和峰值时的 TB 和 IB 水平无差异。

结论

新生儿期胆红素水平低于换血指征的推荐值，与足月和早产儿 NHS 测试的“失败”结果并无直接关系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aab9/10939397/17a261a8480c/codas-36-2-e20220273-g04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aab9/10939397/c2a9c22a70fa/codas-36-2-e20220273-g01-en.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aab9/10939397/3350323af300/codas-36-2-e20220273-g02-en.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aab9/10939397/5078c2f67624/codas-36-2-e20220273-g03-en.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aab9/10939397/08d70e6ec822/codas-36-2-e20220273-g04-en.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aab9/10939397/c448bd7e38fb/codas-36-2-e20220273-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aab9/10939397/ea7c5ff08f9a/codas-36-2-e20220273-g02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aab9/10939397/0eed7ababc5e/codas-36-2-e20220273-g03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aab9/10939397/17a261a8480c/codas-36-2-e20220273-g04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aab9/10939397/c2a9c22a70fa/codas-36-2-e20220273-g01-en.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aab9/10939397/3350323af300/codas-36-2-e20220273-g02-en.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aab9/10939397/5078c2f67624/codas-36-2-e20220273-g03-en.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aab9/10939397/08d70e6ec822/codas-36-2-e20220273-g04-en.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aab9/10939397/c448bd7e38fb/codas-36-2-e20220273-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aab9/10939397/ea7c5ff08f9a/codas-36-2-e20220273-g02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aab9/10939397/0eed7ababc5e/codas-36-2-e20220273-g03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aab9/10939397/17a261a8480c/codas-36-2-e20220273-g04.jpg

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