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Sensorineural hearing loss and prematurity
E S Marlow1, L P Hunt, N Marlow
1Hearing Assessment Centre, University of Bristol, Bristol, UK.
Archives of Disease in Childhood. Fetal and Neonatal Edition
|February 24, 2000
Summary
Very preterm infants with sensorineural hearing loss (SNHL) experienced more intensive perinatal care and neurological complications. The combination of risk factors, rather than individual ones, significantly increased SNHL likelihood in these vulnerable infants.
Area of Science:
- Neonatal Medicine
- Pediatric Audiology
- Neurodevelopmental Pediatrics
Background:
- Sensorineural hearing loss (SNHL) is a significant concern in very preterm infants.
- Identifying clinical antecedents is crucial for early intervention and improved outcomes.
Purpose of the Study:
- To investigate the clinical factors associated with SNHL in infants born before 33 weeks' gestation.
- To determine the relationship between perinatal care, specific treatments, and the development of SNHL.
Main Methods:
- A case-control study comparing 15 infants with SNHL to 30 matched controls.
- Analysis of perinatal variables including birth weight, intubation, ventilation, oxygen use, acidosis, and medication exposure.
- Conditional logistic regression was used to assess the odds of SNHL based on various clinical factors.
Main Results:
- Infants with SNHL required longer intubation, ventilation, and oxygen therapy, and experienced more acidosis.
- SNHL risk increased with co-exposure to high bilirubin levels and netilmicin, or acidosis and elevated bilirubin (>200 micromol/l).
- Frusemide use with high creatinine or netilmicin, and the presence of cerebral palsy at 12 months were associated with SNHL.
Conclusions:
- Very preterm infants with SNHL exhibit a greater need for intensive perinatal care and show increased neurological complications.
- The interplay of multiple risk factors, rather than isolated factors, appears to be more critical in the development of SNHL in this population.