The Hearing Screening Results And High-risk Factors Analysis Of Premature Infants In NICU

Objectives Apply transiently evoked otoacoustic emission (TEOAE) and auditory brain stem response (ABR) to take the neonatal hearing screening for premature infants complicated with different high-risk disease of different gestational age in neonatal intensive care units,and analyze the happening of hearing impairment, in order to discover, diagnose and interfere the hearing disorders in early stage.Methods Choose the premature infants of different gestational ages in NICU of our hospital from January,2009to December,2010as screening subjects. Apply transiently evoked otoacoustic emission (TEOAE) to premature infants in3-5days after birth or in stable condition for preliminary screening.If they do not pass, we will take the TEOAE to rescreen when they are in30-42days after birth.If they do not pass the rescreening, we will take some diagnostic hearing screenings,such as auditory brain stem response (ABR),40Hz-auditory event related potential, Acoustic immittance measurement and so on when they are in3months.Use χ2test and multivariate logistic regression analysis to compare the happening of hearing impairment and the influence of the premature infants complicated with different disease states of different gestational ages on hearing damage.Results A total of862survival premature infants in NICU of Qingdao Children hospital entered the preliminary screening from2009to2010. According to gestational age they were divided into four groups:①GA≤30weeks;②30weeks<GA≤32weeks;③32weeks<GA≤34weeks;④34weeks<GA≤37weeks.The total numbers of each group were58cases,127cases,236cases,441cases. The numbers of not passing through the preliminary screening of each group were48cases,97cases,134cases,224cases and the rates respectively were82.76%,76.38%,56.78%,50.79%.The rates of not passing through the rescreening respectively were42.86%,23.08%,11.68%,7.16%.The rates of not passing through ABR respectively were19.51%,8.42%,3.68%,2.55%.Through χ2test, the difference of each group’s not passing rate of three inspections were significantly (P<0.0001for all).High-risk factors include premature birth, hyperbilirubinemia, lung injury, very low birth weight infants (birth weight<1500g), asphyxia and infection.Using multivariate logistic regression analysis, the results of preliminary screening show:the influence of gestational age on the not passing rates has statistical significance. The smaller the gestational ages are, the higher the not passing rates are (OR=0.499,95%CI:0.274-0.906).Besides, hyperbilirubinemia, very low birth weight, asphyxia, and infection are its risk factors (OR=1.134,1.300,1.111,2.270).The results of rescreening show:the not passing rates of very low birth weight infants are high (OR=2.386,95%CI:1.052-5.415), and hyperbilirubinemia, asphyxia and infection are its risk factors (OR=1.434,1.257,1.906).Conclusions The rates of hearing impairment of premature infants in NICU are high. The smaller the gestational ages are, the higher the risk of hearing damage is.Asphyxia, hyperbilirubinemia, infection and very low birth weight are high-risk factors of hearing impairment. So to strengthen the care of premature infants, prevention of complications, timely hearing screening after birth,and to create the conditions for early intervention are fairly necessary.