CZYNNIKI RYZYKA USZKODZEŃ SŁUCHU U NOWORODKÓW PRZEBYWAJĄCYCH NA ODDZIAŁACH INTENSYWNEJ TERAPII

Abstract

BackgroundNeonatal intensive care unit graduates are considered to be of higher risk for hearing impairment, either auditory neuropathy or hearing loss. In this study we examine the presence of risk factors and try to identify their effect on the hearing of high-risk neonates.Material and MethodsIn this prospective cohort study we used automated auditory brainstem responses (a-ABRs) and otoacoustic emissions (OAEs) to screen 453 neonatal intensive care unit neonates who had at least one risk factor for hearing impairment.ResultsIn the initial examination, 382 (84.3%) infants passed and 71 (15.7%) failed a-ABRs. Out of those who failed, 39 newborns (55%) passed the transiently evoked otoacoustic emission (TEOAE) test, while 32 (45%) failed that test too. Re-examination was performed before their first month of age, eventually resulting in 8 newborns being diagnosed with possible hearing loss and 8 with possible auditory neuropathy. The overall dropout rate was 4.9%. Low birth-weight (p=0.016), as well as craniofacial abnormalities (p=0.03) and TORCH (toxoplasmosis, rubella, cytomegalovirus, herpes) infections proved to have a statistically significant correlation (p=0.05) with hearing impairment.ConclusionsBecause a significant number of children may have auditory neuropathy, ABRs and OAEs (both transiently evoked and distortion product OAEs) remain the cornerstones of any universal hearing screening program in neonatal intensive care units. An efficient tracking system is needed to reduce the number of neonates lost to follow-up. Low birth-weight, craniofacial deformities, and congenital infections appear to be the most significant factors predisposing an infant to hearing impairment.