Sensorineural hearing loss and prematurity
Elaine S Marlowa, Linda P Huntb, Neil Marlowb
a Hearing Assessment
Centre, University of Bristol, Bristol, UK, b Division of Child Health, University of Bristol
Correspondence to: Professor E S Marlow, Department of Child Health, Level E East Block, Queens Medical Centre, Nottingham NG7 2UH, UK
Accepted 13 August
1999
OBJECTIVE
To elucidate
clinical antecedents of sensorineural hearing loss (SNHL) in very
preterm infants.
DESIGNCase-control study.
SUBJECTSFifteen
children < 33 weeks' gestation with significant SNHL born between 1 January 1990 and 31 December 1994, detected within 9 months of birth,
and 30 matched control children.
METHODOLOGYPerinatal
variables in the two groups were compared using non-parametric tests
and conditional logistic regression (EGRET).
RESULTSMedian birth
weight for the index group was 960 g (range 600-2914 g) compared with
1026 g (range 410-2814 g) for controls. Children with SNHL had longer
periods of intubation, ventilation, oxygen treatment, and acidosis, and
more frequent treatment with dopamine or frusemide. Neither peak nor
trough aminoglycoside levels, nor duration of jaundice or level of
bilirubin varied between groups. However, SNHL was more likely if peak
bilirubin levels coexisted with netilmicin use (odds ratio (95%
confidence interval) 14.2 (1.8 to 113.6)) or if acidosis occurred when
bilirubin levels were over 200 µmol/l (OR 8.0 (0.9 to 71.6).
Frusemide use in the face of high serum creatinine levels (OR 8.9 (1.1 to 74.5)) or netilmicin treatment (OR 5.0 (0.99 to 24.8)) was also
associated with SNHL. At 12 months of age, seven of 15 children with
SNHL had evidence of cerebral palsy compared with two of 30 controls (OR 12.3 (2.1 to 71)).
CONCLUSIONSPreterm
children with SNHL required more intensive care in the perinatal period
and developed more neurological complications than controls. Among very
preterm babies, the coexistence of risk factors for hearing loss may be
more important than the individual factors themselves.
Keywords: very preterm infants; hearing; sensorineural hearing loss; bilirubin; creatinine; aminoglycosides
© 2000 by Archives of Disease in Childhood
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