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Hearing loss in very low birthweight infants treated with neonatal intensive care
Insights
Hearing loss affects 30% of very low birthweight infants, with neonatal apnea and high bilirubin levels being key predictors. Incubator noise did not significantly impact hearing outcomes in these survivors.
Area of Science:
- Neonatal Intensive Care
- Pediatric Audiology
- Perinatal Medicine
Background:
- Very low birthweight infants (<1500g) require intensive care.
- Long-term neurodevelopmental outcomes, including hearing, are crucial for survivors.
Purpose of the Study:
- To assess the hearing status of perinatal intensive care survivors with birthweights of 1500g or less.
- To identify predictors of hearing loss in this vulnerable population.
Main Methods:
- Hearing was assessed in 111 very low birthweight survivors at a mean age of 6.5 years.
- Data collected included birthweight, incubator exposure, neonatal apnea, and serum bilirubin levels.
- Hearing loss was categorized as sensorineural, conductive, or due to otitis media.
Main Results:
- 10% had sensorineural hearing loss, 1% had conductive hearing loss, and 19% had otitis media with hearing impairment.
- Neonatal apnea was a significant predictor of hearing loss (P<0.05).
- Elevated indirect serum bilirubin levels (≥170 µmol/l) had an additive effect on hearing loss risk (P<0.05).
Conclusions:
- Hearing impairment is a significant concern in very low birthweight survivors.
- Neonatal apnea and hyperbilirubinemia are critical risk factors for hearing loss.
- Ambient noise in incubators did not demonstrate a significant impact on hearing in this cohort.
Abstract:
The hearing of 111 perinatal intensive care survivors of birthweights 1500 g or less was assessed at a mean age of 6 1/2 years (range 4--12). These 111 infants included 86% of the long-term survivors of this birthweight cared for in the newborn unit of University College Hospital, London, during the years 1966--72. All these infants were nursed in commercially available incubators for periods ranging from 2 to 80 days (mean 37) in which the mean noise threshold was 65 dB. Ten (9%) had sensory neural nearing losses, one (1%) infant had a congenital conductive hearing loss, and 21 (19%) infants had exudative otitis media with a mean loss of 25 dB. Apnoeic attacks in the neotal period were the most significant predictors of hearing loss in these infants (P less than 0.05) and an indirect serum filirubin level of at least 170 micromol/l (10 mg/100 ml) in the neonatal period had an additive effect (P less than 0.05). There was no evidence that ambient noise had affected the hearing of these very low birthweight infants.