BackgroundHearing loss in children born before 32 weeks of gestation is more prevalent than in full term infants. Aminoglycoside antibiotics are routinely used to treat bacterial infections in babies on neonatal intensive care units. However, this type of medication can have harmful effects on the auditory system. In order to avoid this blood levels should be maintained in the therapeutic range. However in individuals with a mitochondrial genetic variant (m.1555A > G), permanent hearing loss can occur even when drug levels are within normal limits. The aim of the study is to investigate the burden that the m.1555A > G mutation represents to deafness in very preterm infants.MethodThis is a case control study of children born at less than 32 completed weeks of gestation with confirmed hearing loss. Children in the control group will be matched for sex, gestational age and neonatal intensive care unit on which they were treated, and will have normal hearing. Saliva samples will be taken from children in both groups; DNA will be extracted and tested for the mutation. Retrospective pharmacological data and clinical history will be abstracted from the medical notes. Risk associated with gentamicin, m.1555A > G and other co-morbid risk factors will be evaluated using conditional logistic regression.DiscussionIf there is an increased burden of hearing loss with m.1555A > G and aminoglycoside use, consideration will be given to genetic testing during pregnancy, postnatal testing prior to drug administration, or the use of an alternative first line antibiotic. Detailed perinatal data collection will also allow greater definition of the causal pathway of acquired hearing loss in very preterm children.

ObjectiveTo investigate individual and concomitant risk factors for hearing loss during neonatal care.DesignCase–control study.SettingCommunity.Population237 children born <32 weeks of gestation; 57 with hearing loss and 180 with normal hearing born between 2009 and 2013, matched for sex, gestation and year of birth.Main outcome measuresData were abstracted from clinical records for overall risk factors daily for the first 14 days and then weekly until discharge from neonatal care. All infants were screened for the presence of m.1555A>G mutation.ResultsChildren with hearing loss had lower birth weight for gestational age, more severe neonatal illness, with increased exposure to inotrope, steroid, gentamicin, vancomycin and furosemide, and more frequent physiological risk, elevated bilirubin and creatinine levels and acidosis, but no index child was found to have the m.1555A>G mutation, compared with one among controls. The duration of gentamicin, vancomycin or furosemide administration in the first 14 days was associated with impaired hearing (OR per dose: 1.25; 95% CI 1.14 to 1.38). Multivariate analyses revealed independent risks for hearing loss for each day when there was physiological risk (OR per day 1.15 (1.05 to 1.27)) and each day of medication exposure (OR 1.23 (1.1 to 1.37)).ConclusionAlthough the relative contribution of underlying illness and medication cannot be identified by this study, cumulative use of ototoxic medication and the presence of physiologic risk factors independently increased the likelihood of hearing loss, warranting close monitoring of coincident therapy throughout neonatal critical care.

Background The use of bedside cameras in neonatal units facilitates livestreaming of infants to support parental and family bonding when they are unable to be physically present with their baby. This study aimed to explore the experiences of parents of infants previously admitted for neonatal care and who used live video streaming to view their baby in real-time. Methods Qualitative semi-structured interviews were conducted after discharge with parents of infants admitted for neonatal care on a tertiary level neonatal unit in the UK in 2021. Interviews were conducted virtually, transcribed verbatim and uploaded into NVivo V12 to facilitate analysis. Thematic analysis by two independent researchers was undertaken to identify themes representing the data. Results Seventeen participants took part in sixteen interviews. Thematic analysis identified 8 basic themes which were grouped into 3 organizational themes: (1) family integration of the baby including parent-infant, sibling-infant, and wider family-infant attachment facilitated through livestreaming, (2) implementation of the livestreaming service including communication, initial set up of the livestreaming service, and areas for improvement, and (3) parental control including emotional, and situational control. Conclusions The use of livestreaming technology can provide parents with opportunities to integrate their baby into their wider family and friendship community and gain a sense of control over their baby’s admission for neonatal care. On-going parental education around how to use, and what to expect from, livestreaming technology is required to minimise any potential distress from viewing their baby online.

BackgroundAdmission of a baby for neonatal care represents a deeply traumatic time for parents. Webcam technology facilitating live‐streaming of the baby when the parents are unable to be physically present has been introduced to support bonding and parental engagement in care.AimThis systematic review explores the impact and experiences of webcam technology upon parents of babies in the neonatal unit and neonatal health care professionals.Study DesignA systematic search of Embase, Medline and Scopus was conducted using the keywords ‘video technology’, ‘newborn’ and ‘neonatal intensive care.’ Studies written in English and exploring live‐stream technology were included. Thematic analysis per group (parents and health care professionals) was undertaken to identify similarities between themes across published studies.ResultsTen studies were included. Six studies explored the impact of webcam technology on parents only, two on both parents and health care professionals and two on health care professionals only. Thematic analysis per group identified three themes for parents, including parental well‐being, parent‐infant bonding and quality of care. Two themes were identified for neonatal health care professionals, including quality of care and feasibility of webcam technology.ConclusionWebcam technology has many documented benefits for parental well‐being. However, new technology requires adequate staff training, support and plans for ongoing maintenance. Further research is required to explore the long‐term impacts on breast‐milk production and infant neurological development.