[Prevalence, Risk Factors and Diagnostics of Hearing Impairment in Preterm Infants]
Insights
Preterm infants require careful auditory monitoring due to high congenital hearing impairment risk. Current clinical practices for hearing screening and treatment in preterm infants often deviate from established guidelines, necessitating improved diagnostics and unified care.
Area of Science:
- Pediatric Audiology
- Neonatology
- Public Health
Background:
- Preterm birth is a significant risk factor for congenital hearing impairment.
- Early detection and intervention are crucial for auditory development in high-risk infants.
- Current clinical practices require evaluation for adherence to established guidelines.
Purpose of the Study:
- To assess the implementation of current scientific findings on hearing impairment in preterm infants.
- To evaluate adherence to diagnostic and therapeutic guidelines in clinical practice.
- To identify discrepancies between recommended and actual care for preterm infants' auditory health.
Main Methods:
- Retrospective analysis of treatment data for 126 preterm children (2006-2011).
- Analysis of screening center records (n=67,640) for prevalence data in Saxony-Anhalt.
- Comparison of implemented practices against guidelines from the G-BA (Gemeinsamer Bundesausschuss).
Main Results:
- Universal postnatal hearing screening is common for preterm infants.
- Practical implementation frequently deviates from G-BA guidelines regarding screening methods (e.g., Automated Auditory Brainstem Response - AABR) and timing.
- Discrepancies exist in screening and treatment timing for preterm infants.
Conclusions:
- Clinical practice for preterm infant hearing impairment often falls short of guideline recommendations.
- Standardization of diagnostics and therapy is needed for equitable care.
- Timely hearing aid fitting can positively impact auditory system maturation and speech development.
Abstract:
Introduction: The preterm birth is clearly associated with increased risk of developing congenital hearing impairment. Therefore, special attention must be paid to the postnatal control of auditory function in all preterm infants. The present work investigates if the latest scientific findings regarding prevalence, clinical diagnostics, therapy and risk factors of hearing impairment in premature infants are regularly implemented in daily practice. Methods: At the department of phoniatrics and pediatric audiology of the University Hospital of Magdeburg, the treatment data of 126 preterm children born between 2006 and 2011 were evaluated retrospectively. The additional analysis of all records available at the screening center (n=67 640) covering this period enables drawing conclusions on the total number and prevalence of hearing impairment in preterm infants in Saxony-Anhalt. Results: Almost all premature babies, like mature newborns, underwent postnatal hearing screening of both ears. The data analysis shows that the practical implementation often does not comply with the guideline of the G-BA (Gemeinsamer Bundesausschuss) in all details. For example, the recommended screening method for preterm infants (AABR) or the screening and treatment timing are not always applied in accordance with the guidelines of the G-BA. Discussion: Assessment of the practical implementation of universal newborn hearing screening was planned at the time of the introduction of the hearing screening program by the G-BA. As a part of this investigation, the practical care of vulnerable groups such as preterm infants must be given special attention. Based on the collected data, the diagnostics and therapy should be unified. Regardless of the maternity clinic where the infants were born, there should be the same opportunity for early diagnosis and thus for prognostically better treatment of congenital hearing impairment. Rapid postnatal fitting with hearing aid can stimulate the maturation of the central auditory system and potentially help to avoid problems of hearing and speech development.
