Prevalence and independent risk factors for hearing impairment among very low birth weight infants
Chien-Ho Wang1, Chang-Yo Yang2, Reyin Lien1
1Division of Neonatology, Department of Pediatrics, Chang Gung Children's Hospital and Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, 33305, Taiwan.
Insights
Hearing impairment affects 3.9% of very-low-birth-weight (VLBW) infants. Independent risk factors include ototoxin use, PDA ligation, craniofacial anomalies, and prolonged oxygen support.
Area of Science:
- Neonatal care
- Audiology
- Public health
Background:
- Auditory handicap is a significant complication in premature infants despite advances in perinatal and neonatal care.
- Hearing impairment poses a serious risk to the development of very-low-birth-weight (VLBW) infants.
Purpose of the Study:
- To determine the prevalence of hearing impairment in VLBW infants.
- To analyze potential risk factors associated with hearing impairment in this vulnerable population.
Main Methods:
- A retrospective study analyzed medical records of VLBW infants (BW ≤ 1500 g) admitted to NICU.
- Hearing screening utilized Brainstem Auditory Evoked Potentials (BAEP) at 3 months corrected age.
- Logistic regression was employed to identify neonatal risk factors for hearing impairment.
Main Results:
- The prevalence of hearing impairment in VLBW infants was 3.9%.
- Independent risk factors identified include ototoxin use (OR: 3.62), PDA ligation (OR: 4.96), craniofacial anomalies (OR: 3.42), and prolonged supplemental oxygen use beyond 36 weeks gestational age (OR: 5.94).
- Mean gestational age was 27.9 weeks and mean birth weight was 1028 g.
Conclusions:
- The incidence of hearing impairment among VLBW infants is 3.9%.
- Prolonged supplemental oxygen use is a significant predictor of hearing impairment.
- Further research into pathophysiological mechanisms is needed to reduce hearing impairment prevalence in VLBW infants.
Background:
Although we've made big strides in perinatal and neonatal care, auditory handicap remains a serious complication in those who were born very premature.
Objectives:
The aim was to determine the prevalence and analyze possible risk factors of hearing impairment in very-low-birth-weight (VLBW) infants.
Materials And Methods:
This was a retrospective study by reviewing medical records of all VLBW infants (BW ≤ 1500 g) admitted to NICU of Chang Gung Children's Hospital over 2 years period from Jan. 2010 to 2011. Brainstem auditory evoked potentials (BAEP) hearing screening was performed at 3 months postnatal corrective age and repeated if failed the 1st time, then refer to ENT doctor if BAEP confirmed abnormal. All VLBW infants examined for hearing impairment were included and data were retrieved retrospectively and analyzed for neonatal risk factors using logistic regression.
Results:
Over the period, 309 VLBW infants were screened. Prevalence of uni- or bilateral hearing impairment was 3.9% (12/309; 95% CI 2.6-4.1). The mean corrective age on diagnosed of hearing impairment was 2.9 ± 1.1 (range 1-5) months. Mean gestational age was 27.9 weeks (SD 1.4) and mean birth weight was 1028 g (SD 180). By univariant analysis for hearing impairment, severe birth asphyxia, craniofacial anomalies, ventilator dependence, patent ductus arteriosus ligation, and use of postnatal ototoxins yielded good prediction of hearing impairment in this population. However, using multivariate analysis revealed that the only independent risk factors for hearing impairment were ototoxins (OR: 3.62; CI: 1.67-7.82), PDA ligation (OR: 4.96; CI: 2.34-10.52), craniofacial anomalies (OR: 3.42; CI: 1.70-6.88)and assisted prolonged use of oxygen at gestational age of >36 weeks (OR: 5.94; CI: 2.61-13.54).
Conclusion:
The incidence of hearing impairment among VLBW infants was 3.9%. Prolonged supplemental oxygen use is a marker for predicting hearing impairment; this requires detailed analysis of the pathophysiologic features, to reduce the prevalence of hearing impairment.
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