UK and US risk factors for hearing loss in neonatal intensive care unit infants
Sally K Thornton1,2, Derek J Hoare1,2, Alice M Yates1
1Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, The University of Nottingham, Nottingham, United Kingdom.
Insights
Neonatal intensive care unit (NICU) admission increases congenital hearing loss risk. UK risk factors are specific but not sensitive; US factors are sensitive but not specific, necessitating further research for optimal surveillance.
Area of Science:
- Neonatal care
- Pediatric audiology
- Congenital disorders
Background:
- Early detection of hearing loss in infants is crucial for development.
- Infants admitted to the neonatal intensive care unit (NICU) are at higher risk for hearing loss.
- Identifying risk factors is vital for effective hearing loss surveillance in high-risk neonates.
Purpose of the Study:
- To evaluate the effectiveness of current UK and US risk factors in identifying congenital hearing loss in infants with NICU admission.
- To compare the sensitivity and specificity of UK and US hearing loss risk factors in a matched cohort.
Main Methods:
- Retrospective cohort study of 142 inborn infants admitted to a tertiary NICU.
- Matched 71 infants with permanent congenital hearing loss to 71 controls based on gestational age, birthweight, and sex.
- Collected data on neonatal indicators and presence of UK and US risk factors for hearing loss.
Main Results:
- 21% of infants with hearing loss had UK risk factors; 86% had US risk factors.
- UK risk factors were highly specific but not sensitive for hearing loss.
- US risk factors were sensitive but not specific, leading to potential false positives.
Conclusions:
- Current UK and US risk factors have limitations in identifying all infants with congenital hearing loss.
- UK factors are precise but miss cases; US factors identify more cases but include false positives.
- Further national studies are needed to develop a combination of risk factors with high sensitivity and specificity for neonatal hearing loss surveillance.
Importance:
Early detection and intervention of hearing loss may mitigate negative effects on children's development. Children who were admitted to the neonatal intensive care unit (NICU) as babies are particularly susceptible to hearing loss and risk factors are vital for surveillance.
Design, Setting And Participants:
This single-centre retrospective cohort study included data from 142 inborn infants who had been admitted to the NICU in a tertiary regional referral centre. Data were recorded for 71 infants with confirmed permanent congenital hearing loss hearing loss. To determine impact of NICU admission independently of prematurity, babies were individually matched with 71 inborn infants on gestational age, birthweight, and sex.
Main Outcomes And Measures:
Neonatal indicators were recorded for all children with permanent congenital hearing loss. Presence of UK and US risk factors for hearing loss were collected on the neonatal population with hearing loss and for the matched controls.
Results:
A fifth (21%) of babies with hearing loss had one or more UK risk factors whereas most (86%) had at least one US risk factor. False positives would be evident if US factors were used whereas the matched controls had no UK risk factors. Ten babies who at birth had no UK or US risk factors did not have any significant neonatal indicators identified in their records, one was ventilated for one day and two had a genetic anomaly.
Conclusions And Relevance:
Current risk factors for hearing loss we identified for follow-up in this high-risk group are highly specific for congenital hearing loss. UK risk factors were highly specific for hearing loss but not sensitive and conversely, US risk factors are sensitive but not specific so false positives would be recorded. A national study of neonatal indicators could provide the utility to test which combinations of risk factors provide high sensitivity without losing specificity.
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