Neonatal Med.  2020 Aug;27(3):126-132. 10.5385/nm.2020.27.3.126.

Hearing Impairments in Preterm Infants: Factors Asso ciated with Discrepancies between Screening and Con firmatory Test Results

• Han JH
• Shin JE
• Lee SM
• Eun HS
• Park MS
• Park KI

• KMID: 2505663
• DOI: http://doi.org/10.5385/nm.2020.27.3.126

Abstract

Purpose
The aim of the study was to investigate risk factors of hearing impairments in preterm infants and analyze factors associated with discrepancies between neonatal hearing screening (NHS) and confirmatory test results.
Methods
We analyzed the medical records of 352 preterm infants born at 23 to 32 weeks’ gestational age (GA) who underwent both automated auditory brainstem response (aABR) and confirmatory ABR (cABR).
Results
Mean GA, mean birth weight, the incidence of small for GA and cesarean section birth were significantly different between the pass and refer groups on aABR and the normal and abnormal groups of cABR. On univariate analysis, bronchopul monary dysplasia (odds ratio [OR], 2.74; 95% confidence interval [CI], 1.00 to 7.48), intraventricular hemorrhage (OR, 7.02; 95% CI, 1.59 to 31.05), and use of furosemide (OR, 3.84; 95% CI, 1.38 to 10.73) were the factors related to refer results on aABR. Peri ventricular leukomalacia (PVL; OR, 4.00; 95% CI, 1.39 to 11.52) and use of vancomycin (OR, 2.86; 95% CI, 1.22 to 6.73) were associated with abnormal cABR. Twenty-five (7.9%) infants had discrepant aABR and cABR results, particularly males and those in whom vancomycin was used.
Conclusion
PVL and use of vancomycin were confirmed as independent risk factors for hearing loss in infants born at less than 32 weeks’ GA. Also, discrepancies between the screening and confirmatory test may occur, especially among male infants and those in whom vancomycin was used. The hearing of infants must be assessed more carefully in such groups regardless of NHS results.

Keyword

Evoked potentials, auditory, brain stem; Hearing loss; Infant, premature

Reference

1. Hirvonen M, Ojala R, Korhonen P, Haataja P, Eriksson K, Gissler M, et al. Visual and hearing impairments after preterm birth. Pediatrics. 2018; 142:e20173888.

2. Wroblewska-Seniuk K, Greczka G, Dabrowski P, Szyfter-Harris J, Mazela J. Hearing impairment in premature newborns: analysis based on the national hearing screening database in Poland. PLoS One. 2017; 12:e0184359.

3. Hille ET, Weisglas-Kuperus N, van Goudoever JB, Jacobusse GW, Ens-Dokkum MH, de Groot L, et al. Functional outcomes and participation in young adulthood for very preterm and very low birth weight infants: the Dutch Project on Preterm and Small for Gestational Age Infants at 19 years of age. Pediatrics. 2007; 120:e587–95.

4. Bielecki I, Horbulewicz A, Wolan T. Risk factors associated with hearing loss in infants: an analysis of 5282 referred neonates. Int J Pediatr Otorhinolaryngol. 2011; 75:925–30.

5. Robertson CM, Howarth TM, Bork DL, Dinu IA. Permanent bilateral sensory and neural hearing loss of children after neonatal intensive care because of extreme prematurity: a thirty-year study. Pediatrics. 2009; 123:e797–807.

6. Wang CH, Yang CY, Lien R, Chu SM, Hsu JF, Fu RH, et al. Prevalence and independent risk factors for hearing impairment among very low birth weight infants. Int J Pediatr Otorhinolaryngol. 2017; 93:123–7.

7. Escobar-Ipuz FA, Soria-Bretones C, Garcia-Jimenez MA, Cueto EM, Torres Aranda AM, Sotos JM. Early detection of neonatal hearing loss by otoacoustic emissions and auditory brainstem response over 10 years of experience. Int J Pediatr Otorhinolaryngol. 2019; 127:109647.

8. American Academy of Pediatrics; Joint Committee on Infant Hearing. Year 2007 position statement: principles and guidelines for early hearing detection and intervention programs. Pediatrics. 2007; 120:898–921.

9. Kuki S, Chadha S, Dhingra S, Gulati A. The role of current audiological tests in the early diagnosis of hearing impairment in infant. Indian J Otolaryngol Head Neck Surg. 2013; 65:244–50.

10. Humphrey C, Veve MP, Walker B, Shorman MA. Long-term vancomycin use had low risk of ototoxicity. PLoS One. 2019; 14:e0224561.

11. Wang LA, Smith PB, Laughon M, Goldberg RN, Ku LC, Zimmerman KO, et al. Prolonged furosemide exposure and risk of abnormal newborn hearing screen in premature infants. Early Hum Dev. 2018; 125:26–30.

12. Hrncic N. Identification of risk factors for hearing impairment in newborns: a hospital based study. Med Glas (Zenica). 2018; 15:29–36.

13. van Dommelen P, Verkerk PH, van Straaten HL; Dutch Neonatal Intensive Care Unit Neonatal Hearing Screening Working Group. Hearing loss by week of gestation and birth weight in very preterm neonates. J Pediatr. 2015; 166:840–3.

14. Kraft CT, Malhotra S, Boerst A, Thorne MC. Risk indicators for congenital and delayed-onset hearing loss. Otol Neurotol. 2014; 35:1839–43.

15. Eras Z, Konukseven O, Aksoy HT, Canpolat FE, Genc A, Sakrucu ED, et al. Postnatal risk factors associated with hearing loss among high-risk preterm infants: tertiary center results from Turkey. Eur Arch Otorhinolaryngol. 2014; 271:1485–90.

16. Ohl C, Dornier L, Czajka C, Chobaut JC, Tavernier L. Newborn hearing screening on infants at risk. Int J Pediatr Otorhinolaryngol. 2009; 73:1691–5.

17. Joint Committee on Infant Hearing; American Academy of Audiology; American Academy of Pediatrics; American Speech-Language-Hearing Association; American Speech-Language-Hearing Association; Directors of Speech and Hearing Programs in State Health and Welfare Agencies. Year 2000 position statement: principles and guidelines for early hearing detection and intervention programs. Pediatrics. 2000; 106:798–817.

18. Jackson W, Taylor G, Selewski D, Smith PB, Tolleson-Rinehart S, Laughon MM. Association between furosemide in premature infants and sensorineural hearing loss and nephrocalcinosis: a systematic review. Matern Health Neonatol Perinatol. 2018; 4:23.

19. Rybak LP, Whitworth C, Weberg A, Scott V. Effects of organic acids on the edema of the stria vascularis induced by furosemide. Hear Res. 1992; 59:75–84.

20. Cristobal R, Oghalai JS. Hearing loss in children with very low birth weight: current review of epidemiology and pathophysiology. Arch Dis Child Fetal Neonatal Ed. 2008; 93:F462–8.

21. Hille ET, van Straaten HI, Verkerk PH; Dutch NICU Neonatal Hearing Screening Working Group. Prevalence and independent risk factors for hearing loss in NICU infants. Acta Paediatr. 2007; 96:1155–8.

22. Gray PH, Sarkar S, Young J, Rogers YM. Conductive hearing loss in preterm infants with bronchopulmonary dysplasia. J Paediatr Child Health. 2001; 37:278–82.

23. Gilles FH, Leviton A. Neonatal white matter damage and the fetal inflammatory response. Semin Fetal Neonatal Med. 2020; Apr. 9. [Epub]. https://doi.org/10.1016/j.siny.2020.101111.

24. Marret S, Vanhulle C, Laquerriere A. Pathophysiology of cerebral palsy. Handb Clin Neurol. 2013; 111:169–76.

25. Zhang Z, Jia X, Guan X, Zhang Y, Lyu Y, Yang J, et al. White matter abnormalities of auditory neural pathway in sudden sensorineural hearing loss using diffusion spectrum imaging: different findings from tinnitus. Front Neurosci. 2020; 14:200.

26. Kim SY, Choi BY, Jung EY, Park H, Yoo HN, Park KH. Risk factors for failure in the newborn hearing screen test in very preterm twins. Pediatr Neonatol. 2018; 59:586–94.

27. Lauer AM, Schrode KM. Sex bias in basic and preclinical noiseinduced hearing loss research. Noise Health. 2017; 19:207–12.