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Published on: November 20, 2015
[Risk factors of hearing impairment in premature infants]
1Klinika Chorób Dzieci Katedry Pediatrii, Wydział Lekarski Uniwersytetu Jagiellońskiego, Kierownik Kliniki i Katedry. tomek.tomasik@gmail.com
Insights
Sensorineural hearing impairment is common in premature infants. Key risk factors include low gestational age, hyperbilirubinemia, severe illness, hypoglycemia, and prolonged amikacin treatment.
Area of Science:
- Neonatal Medicine
- Audiology
- Pediatric Critical Care
Context:
- Premature infants surviving intensive care face a high incidence of sensorineural hearing impairment.
- Identifying specific risk factors is crucial for early intervention and improved outcomes.
Purpose:
- To identify independent risk factors associated with hearing impairment in premature infants.
- To develop a predictive model for hearing impairment in this vulnerable population.
Summary:
- A prospective cohort study analyzed 218 premature infants, identifying low gestational age, hyperbilirubinemia, severe general condition, prolonged catecholamine use, prolonged amikacin treatment, and hypoglycemia as significant risk factors for hearing impairment.
- Mechanical ventilation exceeding 14 days was an additional risk factor linked to gestational age.
- Logistic regression analysis achieved 72% prediction accuracy for hearing impairment cases.
Impact:
- Findings highlight critical factors for targeted screening and preventative strategies in neonatal intensive care units.
- This research aids in optimizing care protocols to mitigate hearing loss in high-risk premature infants.
- Establishes a foundation for further research into the long-term audiological outcomes of preterm infants.
Objective:
The incidence of sensorineural hearing impairment among premature infants--survivors of intensive care--is high. The purpose of this study was to identify the risk factors of hearing impairment in this group of children.
Methods:
Prospective cohort study (2.10.96-17.11.02). A total of 218 premature infants with birth weight 520-3000 g (Me-1300 g) and gestational age 22-36 weeks (Me-30) were tested by ABR and divided into 2 groups: with hearing impairment n = 18 and control n = 200. The logistic regression analysis was performed to identify the independent risk factors of hearing impairment.
Results:
Significant risk factors of hearing impairment were: gestation age (OR: 0.7; 95% CI: 0.6-0.97), hyperbilirubinemia qualified for exchange transfusion (OR: 13; 95% CI: 2.9-64), severe general condition and prolonged use of katecholamines > 8 days (OR: 18; 95% CI: 3.6-96), treatment with amikacin > 15 days (OR: 8; 95% CI: 1.6-43), hypoglycaemia < or = 2.46mmol/l (OR: 6; 95% CI: 1.2-23). Mechanical ventilation > 14 days was an additional risk factor associated with gestational age (OR: 8; 95% CI: 1.1-65). The model evaluated by logistic regression could predict 13 out of 18 hearing impairment cases (72%).
Conclusion:
The independent risk factors of hearing impairment in premature infants are: low gestational age or associated with it prolonged mechanical ventilation, hyperbilirubinemia, severe general condition, hypoglycaemia and prolonged treatment with amikacin.
