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Published on: July 1, 2015
Changes in auditory function in premature children: A prospective cohort study
Irina V Savenko1, Ekaterina S Garbaruk2, Elena A Krasovskaya3
1I.P. Pavlov First St. Petersburg State Medical University, 6-8 L'va Tolstogo St., St. Petersburg, 197022, Russia.
Insights
Auditory function in preterm infants is often unstable, with hearing potentially worsening or improving. Infants born before 31 weeks require extended monitoring until 3-4 years old due to potential auditory changes.
Area of Science:
- Pediatric audiology
- Neonatology
- Developmental pediatrics
Background:
- Preterm birth is associated with increased risk of auditory dysfunction.
- Understanding the trajectory of auditory development in preterm infants is crucial for early intervention.
Purpose of the Study:
- To analyze the age-specific patterns of auditory function in preterm children based on gestational age at birth.
- To identify changes in hearing over time in this vulnerable population.
Main Methods:
- A prospective cohort study of 271 preterm children (22-36 weeks gestational age).
- Hearing was assessed using multiple methods including ABR, ASSR, OAE, and audiometry.
- Longitudinal follow-up varied based on age and initial hearing status.
Main Results:
- Initial auditory impairment (SNHL, ANSD) was observed in both groups, with no significant difference at baseline.
- Long-term follow-up revealed hearing changes in 16 children, predominantly in the very preterm group (born before 31 weeks).
- Observed changes included hearing recovery, late-onset hearing loss, and transformations between ANSD and SNHL.
Conclusions:
- Auditory function in preterm infants is dynamic and can fluctuate, particularly in early childhood.
- Very preterm infants (before 31 weeks gestation) necessitate long-term audiological surveillance until at least 3-4 years of age.
- Delayed cochlear implantation is recommended for infants born before 32 weeks gestation due to potential auditory changes.
Objectives:
To analyze the age-specific pattern of auditory function in preterm children as a function of their gestational age at birth.
Study Design:
longitudinal cohort study.
Methods:
a prospective cohort study involved 271 preterm children aged from 6 months to 15 years old. Children were divided into two groups: 70 children with a gestational age at birth of 32-36 weeks (Group 1) and 201 children with a gestational age of 22-31 weeks (Group 2). Hearing was assessed by ABR, ASSR, OAE, behavioral audiometry, and pure tone audiometry. Additionally, for some children, CT, MRI, and GBJ2 evaluations were performed. Assessments of hearing impaired children were performed 3-4 times a year for children under 2 years of age; 2-3 times a year for children from 2 to 5 years of age; and 1-2 times a year for children over 5 years of age. Infants without any hearing problems were examined 2-3 times during their first year of life, followed by annual examinations as they aged.
Results:
The initial hearing examination identified SNHL and ANSD in 18 children (25.7%) and 64 children (31.8%) in Group 1 and Group 2, respectively. No significant difference in the occurrence of auditory impairment in the two groups was found at the initial assessment (p > 0.05). Further long-term follow-up revealed changes in hearing in 16 children: 15 from Group 2 and only one child from Group 1. Four different kinds of hearing changes were noted: hearing recovery to normal levels in children with ANSD; late onset hearing loss; the transformation of ANSD to SNHL, and vice versa. The age, factors, and possible mechanisms of such changes are discussed in the article.
Conclusion:
The auditory function in prematurely born children tends to be unstable, especially at a very early age. In very preterm infants, it may either deteriorate or improve. Infants born before 31 weeks' gestation require long-term follow-up at least until they are 3-4 years of age. Caution is advised regarding very early cochlear implantation for children born before 32 weeks of gestation age.
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