Antenatal factors modulate hearing screen failure risk in preterm infants

Area of Science:

• Neonatal Health
• Perinatal Medicine
• Audiology

Background:

• Neonatal hearing loss is a significant concern in very low birthweight (VLBW) infants.
• Antenatal factors, including inflammation, may impact neonatal hearing outcomes.
• Maternal therapies during pregnancy are increasingly recognized for their potential to influence neonatal health.

Purpose of the Study:

• To investigate the association between antenatal inflammatory markers and maternal therapies with neonatal hearing screen results in VLBW infants.
• To identify specific risk factors for hearing screen failure in this vulnerable population.
• To evaluate the protective effects of certain maternal treatments on hearing outcomes.

Main Methods:

• Retrospective cohort study of VLBW infants (<33 weeks GA, <1501g birth weight) enrolled between 1999-2003.
• Analysis included placental pathology, cord blood inflammatory markers (IL-6, IL-1ß, TNF-α), and neonatal hearing screen data.
• Logistic regression models were used to determine risk factors for hearing screen failure.

Main Results:

• Of 289 infants, 16% failed the hearing screen.
• Fetal inflammatory response syndrome (fetal vasculitis and/or high cord IL-6) was a significant risk factor for hearing screen failure (OR 3.62).
• Indomethacin treatment for patent ductus arteriosus increased hearing screen failure risk (OR 3.3), while maternal steroid and magnesium sulfate exposure reduced risk (OR 0.37).

Conclusions:

• Intrauterine infection and fetal inflammatory response are key risk factors for neonatal hearing loss in VLBW infants.
• Maternal therapies, specifically combined steroid and magnesium sulfate use, significantly mitigate the risk of neonatal hearing loss.
• These findings highlight the importance of managing intrauterine inflammation and utilizing protective maternal treatments in VLBW infants.