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Risk factors for sensorineural hearing loss in extremely premature infants
G I Leslie1, M B Kalaw, J R Bowen
1Department of Neonatology, Royal North Shore Hospital, St Leonards, New South Wales, Australia.
Objective:
To identify potentially preventable risk factors for sensorineural hearing loss (SNHL) in extremely premature infants.
Methodology:
A case control study of survivors with gestational age (GA) < 28 weeks or birthweight (BW) < 1000 g using data collected prospectively in our Neonatal Intensive Care Unit database. Each subject with bilateral SNHL > 40 dB was matched according to GA, BW and sex with two controls who had neither sensorineural nor conductive hearing loss.
Results:
Infants with SNHL had increased mean (+/- s.d.) days ventilated (53 +/- 21 vs 37 +/- 23 days, P = 0.006) and in oxygen (107 +/- 44 vs 69 +/- 28 days, P = 0.02) compared with controls. The risk for SNHL was increased for infants who spent > 90 days in oxygen (OR 4.0 [95% CI 1.1-15.6]), had maximum FiO2 > 0.90 (5.6 [1.2-26.9]), minimum plasma Na < 125 mmol/L (5.6 [1.1-27.8] or maximum pH > 7.60 (5.6 [1.1-89.0]). Neither maximum serum bilirubin nor exposure to ototoxic drugs was associated with SNHL.
Conclusions:
Avoidance of severe hyponatraemia and extreme alkalosis, as well as use of surfactant to minimize the severity of hyaline membrane disease, may result in a decreased incidence of SNHL in extremely premature infants.