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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Prediction of 8-month MEE from neonatal risk factors and test results in SCBU and full-term babies
1Audiology Unit, Royal Berkshire Hospital, Reading, UK.
Insights
Neonatal tympanometry and breastfeeding predict middle ear effusion (MEE) in special care babies. For other infants, colds and parental smoking are key risk factors for MEE persistence.
Area of Science:
- Pediatrics
- Otolaryngology
- Neonatology
Background:
- Middle ear effusion (MEE) incidence and persistence are influenced by birth and environmental factors.
- Risk factors for persistent MEE include bottle-feeding, parental smoking, special care admission, and colds.
Purpose of the Study:
- To identify risk factors and neonatal test results predicting MEE at 8 months of age.
- To evaluate the predictive value of neonatal tympanometry for MEE.
Main Methods:
- One hundred Special Care Baby Unit (SCBU) and non-SCBU infants were assessed neonatally and at 8 months using tympanometry.
- Risk factors were collected at each assessment.
- 220 Hz tympanometry measured MEE at 8 months.
Main Results:
- For SCBU babies, neonatal 660 Hz tympanometry and breastfeeding status best predicted 8-month MEE.
- For non-SCBU babies, a history of colds and parental smoking significantly predicted 8-month MEE.
- Neonatal 660 Hz tympanometry may offer insights into neonatal MEE.
Conclusions:
- Neonatal tympanometry and breastfeeding are predictive of MEE in SCBU infants.
- Environmental factors like colds and parental smoking are significant predictors for non-SCBU infants.
- Larger studies are needed to confirm predictive models for neonatal MEE risk.
Abstract:
The incidence and persistence of middle ear effusion (MEE) may be affected by children's birth history and environment. Factors such as bottle-feeding, presence of parental smoking, admission to special care and a history of colds are all thought to increase the risk of persistent MEE. The aim of the present study was to determine those risk factors and neonatal test results that best predict presence of MEE (as measured by 220 Hz tympanometry) at 8 months of age. One hundred Special Care Baby Unit (SCBU) and non-SCBU babies were assessed neonatally and at 8 months of age with tympanometry. At each assessment, various risk factors were collected. Failure of 8-month tympanometry was best predicted by neonatal (660 Hz) tympanometry and the presence or absence of breast-feeding for SCBU babies. This provides further evidence that 660 Hz tympanometry may provide information about neonatal MEE. For non-SCBU babies the risk of failing 8-month tympanometry was most significantly affected by a history of colds and parental smoking. The number of babies with each combination of risk factors in the present study is rather small and this has caused confidence intervals (CIs) to be wide and some unexpected results. However, an extended study with a larger and more balanced sample may facilitate accurate prediction neonatally of those children at risk of 8-month MEE.
