Hearing screening in a neonatal intensive care unit

Abstract

Objective: Investigate the prevalence of hearing impairment in newborns hospitalized at the Intensive and Intermediate Care Unit at the Womens Comprehensive Health Center Neonatology Service (UNICAMP) and associated risk factors.Methods: 979 newborn babies were assessed between January 2000 and January 2003, through automated auditory brainstem response (AABR) (ALGO 2e color screener). The result was considered normal when the newborn showed response to a 35dBNA signal bilaterally. The prevalence of AABR impairment and the odds ratio were analyzed with a 95% confidence interval using bivariate analysis. To identify the independent risk factors for hearing alterations, multivariate analyses were used with logistic regression.Results: The prevalence of AABR impairment was 10.2%, of which 5.3% was unilateral and 4.9% bilateral. From the multivariate analyses, the following observations were made: family history of congenital hearing loss (OR = 5.192; p = 0.016), craniofacial deformity (OR = 5.530; p < 0.001), genetic syndromes associated with hearing loss (OR = 4.212; p < 0.001), weight below 1,000 g (OR = 3.230; p < 0.001), asphyxia (OR = 3.532; p < 0.001), hyperbilirubinemia (OR = 4.099; p = 0.002) and use of mechanical ventilation (OR = 1.826; p < 0.031) were the indicators that best characterized the group at risk for hearing impairment. Conclusions:The prevalence of hearing impairment using AABR is high. Therefore, it is essential for all newborns who present isolated or associated risk factors to undergo hearing screening in situations in which it is not possible to have universal hearing screening.J Pediatr (Rio J). 2006;82(2):110-4: Newborn, diagnosis, hearing loss. ResumoObjetivo: Avaliar a prevalência de alterações auditivas em recém-nascidos internados na unidade de terapia intensiva e cuidados intermediários do serviço de neonatologia do Centro de Assistência Integral à Saúde da Mulher, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, e analisar os fatores de risco associados.Métodos: Foram avaliados 979 recém-nascidos no período de janeiro de 2000 a janeiro de 2003, utilizando-se a audiometria automá-tica de tronco encefálico (AABR), com aparelho ALGO-2e color -Natus. O resultado foi considerado normal quando o recém-nascido apresentou resposta para 35 dBNA bilateralmente. Foi analisada a prevalência de AABR alterada e odds ratio com intervalo de confiança de 95% em análise bivariada. Para identificar os fatores de risco independentes para AABR alterada, foi feita análise múltipla com modelo de regressão logística.Resultados: A prevalência de alteração no AABR foi de 10,2%, sendo 5,3% unilateral e 4,9% bilateral. Pela análise multivariada, observamos que: antecedente familiar (OR = 5,192; p = 0,016), malformação craniofacial (OR = 5,530; p < 0,001), síndrome genética (OR = 4,212; p < 0,001), peso menor que 1.000 g (OR = 3,230; p < 0,001), asfixia (OR = 3,532; p < 0,001), hiperbilirrubinemia (OR = 4,099; p = 0,002) e uso de ventilação mecânica (OR = 1,826; p < 0,031) foram os in...

Deficiência auditiva na toxoplasmose congênita detectada pela triagem neonatal

“…This child was born severely affected by the infection and presented other risk factors for hearing loss besides parasitosis (low birth weight and long term use of assisted ventilation), and developed hearing and ocular sequelae despite treatment. Hearing loss occurring because of assisted ventilation for more than five days can be associated with the noise produced by the breathing devices, mechanical ventilation duration and involved pulmonary pathologies 5 . As far as birth weight is concerned, although such child presented with low birth weight, hypoacusis risk is greater in newborn with birth weight below 1,500g, although we can not disregard perinatal care situations 5 .…”

“…Hearing loss occurring because of assisted ventilation for more than five days can be associated with the noise produced by the breathing devices, mechanical ventilation duration and involved pulmonary pathologies 5 . As far as birth weight is concerned, although such child presented with low birth weight, hypoacusis risk is greater in newborn with birth weight below 1,500g, although we can not disregard perinatal care situations 5 . Therefore, in this child we can not relate hearing loss with toxoplasmosis, although the clinical picture she had characterizes a severe disease stage.…”

“…This piece of equipment has two recording channels. Responses were captured by means of silver electrodes placed on the ear lobes (A1 and A2), nose (Nz) and forehead (Fz), keeping the impedance below 5 Kohms.…”

“…During childhood, it has a world prevalence of 1/1000 live births 3,4 , being higher (2-4%) among those coming from neonatal intensive care units (ICU) 2,5 . It is associated with genetic and environmental factors; however, in a significant number of children the etiology is unknown 4,6 .…”

“…It is associated with genetic and environmental factors; however, in a significant number of children the etiology is unknown 4,6 . Among risk factors for hypoacusis, we have a family history of hearing deficit, craniofacial malformation, genetic syndrome, birth weight below 1000g, asphyxia, hyperbilirubinemia and mechanical ventilation use 5 .…”