Effects Of High Risk Factors On Infants’ Hearing And Speech Development

Background and ObjectiveHearing impairment is one of the common congenital diseases of newborns,which has caused a heavy burden to the family and society.The incidence of hearing impairment in normal newborns is 1 to 3‰,while the incidence in newborns with high risk factors is 50 times as high as that in normal children,at 2 to 5%^[1-2],With the development of perinatal health care technology,the number of newborns with high risk factors,especially the coexistence of multiple high risk factors,is increasing gradually.Newborn hearing loss risk factors include:high blood bilirubin（serum bilirubin level or higher 342 mu mol/L）,birth weight<1500 g,etc.,the class children with hearing loss has the characteristics of late onset,secretiveness,volatility,and auditory nerve injury is heavier,even by early screening,may occur late onset hearing loss,so the hearing language ability dynamic monitoring is very important^[3-4].To analyze the hearing test results of infants with high risk factors,and to explore the influence of high risk factors on hearing and speech development through follow-up.Clinical data and methodsSelected from January 2018 to December 2018 was born in our hospital,and after into and exclusion standard treatment complete clinical data of 584 cases of patients with high risk factors of neonatal and 600 cases of normal neonatal birth as the research object,the high-risk infants group 307 cases（52.57%）were male,female277 cases（47.43%）,gestational age（27 weeks+1 d～36 weeks+3 d）,birth weight（1.02～5.19 Kg）,natural birth in 354 cases（60.62%）,230 cases of cesarean section（39.38%）,single tire 548 cases 93.84%),There were 36 twins（6.16%）.In the normal infant group,there were 319 males（53.17%）and 281 females（46.83%）,gestational age（38 weeks+1 d～40 weeks+3 d）,birth weight（2.64～3.89Kg）,416 vaginal deliveries（69.33%）,184 cesarean deliveries（30.67%）,single births（592 cases）and twins（8 cases）,respectively.Hearing screening was performed using Transient evoked otoacoustic emission（TEOAE）one day before discharge.Transient evoked otoacoustic emission and automatic auditory brainstem response was used for hearing re-screening within 42 days regardless of whether the initial screening was passed.At 3 months of age,diagnostic auditory brainstem response（ABR）,acoustic conductance,ASSR,behavioral audiometry and other examinations were performed for those who failed the re-screening.At the same time,the two groups of infants were evaluated for follow-up to 18 months of age using the Hearing and Speech Development Observation Chart for Infants and Child Auditory and Speech Development and the Gesell Development Scale,and the results of the two groups were compared.Statistical analysis was performed using SPSS23.0.Results1.The failure rate of primary screening,re-screening,hearing diagnosis at 3months of age and hearing follow-up results in high-risk infants were significantly higher than those in normal infants,and the difference was statistically significant（P<0.05）.2.At 3 months of age,the final diagnosis included 13cases of mild hearing loss in both ears（1 case was in the normal group）,2 case of moderate hearing loss in left ear,3 case of moderate hearing loss in both ears,2 cases of extremely severe hearing loss in both ears,5 cases of left ear secretory otitis media（1 case was in the normal group）,2 cases of auditory neuropathy,and 1 case of left ear deformity.One asymptomatic high-risk child was found to have hearing loss at 9 months of age.Two 3-month-old high-risk infants with hearing loss were found to have improved hearing at 12 months of age,and one of them had increased hearing loss at 18 months of age.One child who received hearing aid improved hearing at the age of 18 months.3.The developmental quotient（DQ）of 9,12 and 18-month-old normal group was92.10±2.68、91.79±2.65、93.37±2.46,and the high-risk infants group was 90.34±5.76、89.78±4.70、88.98±4.78.The differences between the groups were statistically significant（P<0.05）.Conclusions1.Newborns with high risk factors have a high incidence of hearing impairment,and have the characteristics of delay and volatility.They are the key population for hearing screening and follow-up.2.High risk factors increases the hearing screening failure rate and delays the age of speech development.Follow-up should be strengthened,early detection,early diagnosis and treatment.