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Perinatal risk factors in preterm infants with moderate-to-profound hearing deficits
A G Pettigrew1, D A Edwards, D J Henderson-Smart
1Department of Physiology, University of Sydney, NSW.
Insights
Preterm infants with prolonged aminoglycoside therapy face higher risks of hearing loss. Early identification through brainstem auditory-evoked responses before intensive care unit discharge is recommended for at-risk infants.
Area of Science:
- Neonatal Medicine
- Audiology
- Perinatal Research
Background:
- Hearing impairment is a significant concern in preterm infants.
- Identifying perinatal risk factors for auditory development is crucial.
Purpose of the Study:
- To examine perinatal factors associated with hearing loss in preterm infants.
- To compare risk factors between hearing-impaired and normal-hearing preterm infants.
Main Methods:
- Retrospective analysis of perinatal histories of 16 preterm infants with hearing loss.
- Comparison with 226 preterm infants and 16 matched controls with normal hearing.
- Statistical analysis of 11 potential risk factors, including aminoglycoside therapy duration.
Main Results:
- Eight perinatal factors were more frequent in hearing-impaired infants compared to a larger preterm cohort.
- No significant differences were found when matched with normal-hearing controls.
- Prolonged aminoglycoside therapy (mean 15 days vs. 8 days) was significantly associated with hearing deficit.
Conclusions:
- Younger, smaller preterm infants with complicated perinatal courses and extended aminoglycoside exposure are at increased risk for auditory handicap.
- Early identification of hearing deficits in preterm infants is recommended using brainstem auditory-evoked responses before NICU discharge.
Abstract:
The perinatal histories of 16 preterm infants with confirmed moderate-to-profound hearing loss were examined to determine the perinatal factors that might have been associated with their abnormal auditory development. Of the 11 factors that were examined, eight factors occurred significantly more frequently in hearing-impaired infants when they were compared with 226 preterm infants who were cared for in the same intensive care unit in 1984. However, when the histories of the 16 infants with hearing loss were compared with those of 16 infants with normal hearing, who were matched according to gestational age, birthweight percentile and sex, there were no differences. The prevalence of aminoglycoside therapy was high in both groups of infants, but the mean duration of therapy in the infants with a hearing deficit was significantly longer (15 days compared with eight days; P less than 0.025). These observations suggest that younger, smaller, preterm infants with a complicated perinatal course and prolonged aminoglycoside therapy are at higher risk of auditory handicap. We recommend that the early identification of preterm infants with a hearing deficit should be achieved by recording brainstem auditory-evoked responses just before discharge from the intensive care unit.