Hemmingsen Dagny, Moster Dag, Engdahl Bo Lars, Klingenberg Claus
Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of North Norway, Tromso, Norway
Paediatric Research Group, UiT The Arctic University of Norway Faculty of Health Sciences, Tromso, Norway.
Arch Dis Child Fetal Neonatal Ed. 2024 Dec 20;110(1):68-74. doi: 10.1136/archdischild-2024-326870.
To investigate the risk for sensorineural hearing impairment (SNHI) in preterm infants, and to what extent the risk is attributed to perinatal morbidities and therapies.
Population-based cohort study using data from several nationwide registries.
Norwegian birth cohort 1999-2014, with data on SNHI until 2019.
60 023 live-born preterm infants, divided in moderate-late preterm (MLP) infants (32-36 weeks), very preterm (VP) infants (28-31 weeks) and extremely preterm (EP) infants (22-27 weeks), and a reference group with all 869 797 term-born infants from the study period.
SNHI defined by selected ICD-10 codes, recorded during minimum 5-year observation period after birth.
The overall SNHI prevalence in the preterm cohort was 1.4% compared with 0.7% in the reference group. The adjusted risk ratios (95% CIs) for SNHI were 1.7 (1.5-1.8) in MLP infants, 3.3 (2.8-3.9) in VP infants and 7.6 (6.3-9.1) in EP infants. Among EP infants, decreasing gestational age was associated with a steep increase in the risk ratio of SNHI reaching 14.8 (7.7-28.7) if born at 22-23 weeks gestation. Among the VP and MLP infants, mechanical ventilation and antibiotic therapy had strongest association with increased risk of SNHI, but infants not receiving these therapies remained at increased risk. Among EP infants intracranial haemorrhage increased the already high risk for SNHI. We found no signs of delayed or late-onset SNHI in preterm infants.
Preterm birth is an independent risk factor for SNHI. Invasive therapies and comorbidities increase the risk, predominantly in infants born after 28 weeks gestation.
调查早产儿感音神经性听力障碍（SNHI）的风险，以及该风险在多大程度上归因于围产期疾病和治疗。
基于人群的队列研究，使用来自多个全国性登记处的数据。
挪威1999 - 2014年出生队列，有截至2019年的SNHI数据。
60023例活产早产儿，分为中度晚期早产儿（MLP，32 - 36周）、极早产儿（VP，28 - 31周）和超早产儿（EP，22 - 27周），以及一个参考组，包括研究期间所有869797例足月儿。
根据选定的ICD - 10编码定义的SNHI，在出生后至少5年的观察期内记录。
早产儿队列中SNHI的总体患病率为1.4%，而参考组为0.7%。MLP婴儿SNHI的校正风险比（95%CI）为1.7（1.5 - 1.8），VP婴儿为3.3（2.8 - 3.9），EP婴儿为7.6（6.3 - 9.1）。在EP婴儿中，孕周越小，SNHI风险比急剧增加，若孕22 - 23周出生，风险比达到14.8（7.7 - 28.7）。在VP和MLP婴儿中，机械通气和抗生素治疗与SNHI风险增加的关联最强，但未接受这些治疗的婴儿风险仍增加。在EP婴儿中，颅内出血增加了本就很高的SNHI风险。我们未发现早产儿有迟发性或晚发性SNHI的迹象。
早产是SNHI的独立危险因素。侵入性治疗和合并症会增加风险，主要发生在孕28周后出生的婴儿中。
