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[Effect of prenatal glucocorticoid therapy on hearing screening in premature infants]
Li Li1, Lu Wei2, Zhangzhen Chen3
1Department of Neonatology，Jiangxi Maternal and Child Health Hospital，Nanchang，330006，China.
Insights
Prenatal dexamethasone (DXM) therapy improved initial hearing screening pass rates in preterm infants. Optimal results were seen with adequate doses administered 48 hours to 7 days before birth.
Area of Science:
- Neonatal Medicine
- Pharmacology
- Audiology
Context:
- Premature infants face higher risks of hearing impairment.
- Prenatal glucocorticoids are used to accelerate fetal lung maturation.
- The impact of prenatal dexamethasone on neonatal hearing is not fully understood.
Purpose:
- To investigate the effect of prenatal dexamethasone (DXM) on hearing screening outcomes in preterm infants.
- To analyze the influence of DXM dosage and timing on preliminary hearing screening.
- To identify factors affecting secondary hearing screening in this population.
Summary:
- A retrospective analysis of 693 preterm infants showed a significantly higher initial hearing screening pass rate in the DXM group (53.9%) compared to the non-DXM group (35.6%).
- Adequate prenatal DXM doses (≥4 doses) and administration 48 hours to 7 days prior to birth were associated with improved preliminary hearing screening success.
- Secondary hearing screening pass rates were not significantly correlated with DXM but were influenced by gestational age, birth weight, ventilation, and neonatal conditions like bronchopulmonary dysplasia.
Impact:
- Prenatal dexamethasone, when administered adequately within a specific timeframe, positively influences preliminary hearing screening in preterm neonates.
- Bronchopulmonary dysplasia emerged as an independent risk factor for referral in secondary hearing screening.
- Findings suggest optimizing prenatal steroid protocols may benefit early hearing detection in vulnerable preterm populations.
Abstract:
Objective:To explore the effect of prenatal glucocorticoids therapy on hearing screening in premature infants Methods:Data of 693 preterm infants with gestational age of 24-34+6weeks admitted to theJiangxi Maternal and Child Health Hospital within 24 h after birth from June 2022 to June 2023 were retrospectively analyzed. The infants were divided into the DXM group （544 cases） and the non-DXM group （149 cases） based on whether dexamethasone （DXM） was administered prenatally. General data of preterm infants and parturients in two groups were compared, and the effects of different doses and timing of DXM on hearing screening were analyzed. Results:In the terms of preliminary hearing screening. the pass rate of initial hearing screening in DXM group was significantly higher than that in non-DXM group（53.9% vs 35.6%）, with statistical significance（P<0.05）. Further subgroup analysis showed that the passing rate of preliminary hearing screening in adequate prenatal dose（=4 doses） DXM group（58.1%） was significantly higher than that in insufficient group（48.0%） and excessive group（42.4%）, with statistical significance（P<0.05）. Administering DXM 48 hours to 7 days before birth resulted in a higher pass rate for initial hearing screening compared to administration <48 hours or >7 days before birth （56.4% vs. 48.6%）, with a statistically significant difference （P < 0.05）. In terms of re-hearing screening, the pass rate of secondary hearing screening was not significantly correlated with DXM treatment（P>0.05）, but was significantly correlated with gestational age, birth weight, hospital stays, invasive mechanical ventilation, and common neonatal diseases（bronchopulmonary dysplasia, respiratory distress syndrome）（P<0.05）. Among them, bronchopulmonary dysplasia was an independent risk factor forsecondary hearing screening referral（P<0.05）. Conclusion:A single course of adequate dexamethasone use within 48 h-7 d of prenatal has a positive effect on the preliminary hearing screening of preterm infants.
