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Published on: December 9, 2022
Postnatal risk factors associated with hearing loss among high-risk preterm infants: tertiary center results from
Zeynep Eras1, Ozlem Konukseven, Hatice Tatar Aksoy
1Developmental Behavioral Pediatrics Unit, Department of Neonatology, Zekai Tahir Burak Women Health and Education Hospital, Ankara, Turkey, zeyneperas@yahoo.com.
Insights
This study found that 1.4% of high-risk preterm infants experienced permanent hearing loss. Key risk factors include sepsis, prolonged mechanical ventilation, loop diuretics, and surgery for retinopathy of prematurity.
Area of Science:
- Neonatal care
- Audiology
- Pediatric medicine
Background:
- High-risk preterm infants face increased risks for developmental issues, including hearing loss.
- Newborn hearing screening (NHS) is crucial for early detection in vulnerable neonates.
- Identifying specific postnatal risk factors can guide preventative strategies.
Purpose of the Study:
- To determine the prevalence of hearing loss in high-risk preterm infants.
- To identify postnatal risk factors associated with hearing loss in this population.
- To inform targeted interventions for hearing loss prevention.
Main Methods:
- Retrospective study of 1,360 preterm infants (gestational age ≤32 weeks and/or birth weight ≤1,500 g).
- Newborn hearing screening using automated auditory brainstem response (AABR) and automated evoked otoacoustic emission (TEOAE).
- Multivariate analysis to identify significant postnatal risk factors for hearing loss.
Main Results:
- Permanent hearing loss was identified in 1.4% (19 infants).
- Significant risk factors included proven sepsis, mechanical ventilation (≥5 days), loop diuretics, patent ductus arteriosus ligation, and retinopathy of prematurity (ROP) surgery.
- A novel association between ROP surgery and hearing loss was observed.
Conclusions:
- The prevalence of hearing loss in this high-risk preterm cohort is low.
- Specific postnatal factors, including ROP surgery, are significantly associated with hearing loss.
- Neonatal intensive care units should establish tailored risk factor assessments and preventative measures for hearing loss.
Abstract:
The aim of this study was to determine the postnatal risk factors associated with hearing loss as well as the prevalence of hearing loss among high-risk preterm infants in newborn hearing screening (NHS). We performed a retrospective study of high-risk preterm infants born with a gestational age ≤32 weeks and/or a birth weight ≤1,500 g. A NHS procedure was performed by automated auditory brainstem response (AABR) and automated evoked otoacoustic emission (TEOAE). Infants who failed TEOAE or AABR or both tests were referred to a tertiary audiology center for diagnosis confirmation and management. Postnatal risk factors associated with hearing loss were evaluated and compared for preterm infants with and without hearing loss. 1,360 high-risk preterm infants were assessed. Permanent hearing loss was found in 19 (1.4%) infants. Multivariate analysis revealed that proven sepsis (p = 0.019), mechanical ventilation ≥5 days (p = 0.024), loop diuretics (p = 0.001), patent ductus arteriosus ligation (p = 0.018) and operation for retinopathy of prematurity (ROP) (p = 0.034) were significant related factors for the hearing loss. This study showed a low prevalence of hearing loss and an association between operation for ROP and hearing loss in preterm infants, which has not been defined previously. Our results suggest that every neonatal intensive care unit should determine their own risk factors and take precautions to prevent hearing loss for these high-risk preterm infants.
