de Vries L S, Lary S, Dubowitz L M
Pediatrics. 1985 Sep;76(3):351-4.
During a 4-year period, 12 premature infants, all less than 34 weeks of gestation and all with a bilirubin level above 240 mumol/L (14 mg/dL) were determined to have bilateral sensorineural deafness. In order to to investigate how far the hyperbilirubinemia or any a associated factor might have been a causative factor, all infants of 34 weeks of gestation or less who had a serum bilirubin level above 240 mumol/L were investigated. For a period of 4 years, 99 infants meeting these criteria were classified as high risk or low risk on the basis of perinatal risk factors. Eight of the 22 high-risk infants with birth weight less than 1,500 g, but only two of 43 high-risk infants with birth weight greater than 1,500 g were deaf (P less than .05). The deaf infants were also matched with infants of normal hearing who had similar bilirubin levels and the same number of adverse perinatal factors. The mean duration of hyperbilirubinemia was significantly longer in the deaf infants (P less than .02), and they appeared to have a greater number of acidotic episodes while they were hyperbilirubinemic. These findings suggest that in healthy preterm infants with birth weight greater than 1,500 g, high bilirubin levels carry little risk, whereas a serum bilirubin level greater than 240 mumol/L in high-risk preterm infants with birth weight of 1,500 g or less is associated with a high risk of deafness.
在4年期间，12名早产儿被确定患有双侧感音神经性耳聋，这些早产儿均小于34周妊娠，且胆红素水平均高于240 μmol/L（14 mg/dL）。为了研究高胆红素血症或任何相关因素可能在多大程度上是致病因素，对所有妊娠34周及以下且血清胆红素水平高于240 μmol/L的婴儿进行了调查。在4年期间，99名符合这些标准的婴儿根据围产期危险因素被分为高风险或低风险。22名出生体重小于1500 g的高风险婴儿中有8名耳聋，但43名出生体重大于1500 g的高风险婴儿中只有2名耳聋（P小于0.05）。耳聋婴儿还与听力正常、胆红素水平相似且围产期不良因素数量相同的婴儿进行了匹配。耳聋婴儿的高胆红素血症平均持续时间明显更长（P小于0.02），并且在高胆红素血症期间他们似乎有更多的酸中毒发作。这些发现表明，对于出生体重大于1500 g的健康早产儿，高胆红素水平风险很小，而出生体重1500 g及以下的高风险早产儿血清胆红素水平高于240 μmol/L与耳聋的高风险相关。
