Roberts J L, Davis H, Phon G L, Reichert T J, Sturtevant E M, Marshall R E
J Pediatr. 1982 Aug;101(2):257-63. doi: 10.1016/s0022-3476(82)80136-4.
Seventy-five neonatal intensive care unit patients with given auditory brainstem response screening tests at 40 db and 70 db above the normal adult hearing threshold. The presence of wave V, the criterion for pass, was strongly related to postconceptual age: It appeared at 70 db in 50% of the infants tested at 32 weeks' PCA and at 40 db in 50% of the infants tested at 40 weeks' PCA. Forty-four infants failed the last test before NICU discharge (15 at 70 db and 29 at 40 db), but most infants were discharged at a PCA of less than 40 weeks. No significant correlation appeared between ABR test failure and intraventricular hemorrhage, hyaline membrane disease, perinatal asphyxia, hyperbilirubinemia, or aminoglycoside therapy. Follow-up information was obtained in 23 of the 36 "failing" infants who survived (8 died). This consisted of definitive hearing tests in ten patients and historical information supporting normal auditory function in 13 patients. One case of severe hearing loss was confirmed. Thus, most failures of the ABR screen apparently resulted from immaturity. These data raise doubts regarding the effectiveness of ABR screening in the NICU.
75名新生儿重症监护病房的患者接受了在高于正常成人听力阈值40分贝和70分贝时的听觉脑干反应筛查测试。波V的出现作为通过标准，与孕龄密切相关：在孕32周接受测试的婴儿中，50%在70分贝时出现波V；在孕40周接受测试的婴儿中，50%在40分贝时出现波V。44名婴儿在新生儿重症监护病房出院前的最后一次测试中未通过（15名在70分贝时未通过，29名在40分贝时未通过），但大多数婴儿出院时的孕龄小于40周。听觉脑干反应测试未通过与脑室内出血、透明膜病、围产期窒息、高胆红素血症或氨基糖苷类药物治疗之间未出现显著相关性。在36名“未通过”且存活的婴儿中，有23名获得了随访信息（8名死亡）。其中包括10名患者的明确听力测试以及13名患者支持正常听觉功能的病史信息。确诊了1例严重听力损失病例。因此，听觉脑干反应筛查未通过大多显然是由于不成熟所致。这些数据对新生儿重症监护病房中听觉脑干反应筛查的有效性提出了质疑。
