Nongenetic causes of hearing loss

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...

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“…However, in the multiple analysis, in which we attempted to eliminate the joint action of various other factors, this association was not maintained. 17,26 As regards hyperbilirubinemia, the data in the literature point it out as an important cause of deafness. 27 In the present study assessment, it was not identified as a risk factor in the bivariate analysis.…”

Section: Discussionmentioning

confidence: 99%

Triagem auditiva em recém-nascidos internados em UTI neonatal

Lima¹,

Marba²,

Santos³

2006

J. Pediatr. (Rio J.)

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Objective: Investigate the prevalence of hearing impairment in newborns hospitalized at the Intensive and Intermediate Care Unit at the Women s 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.

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“…Risk indicators that are marked with a section symbol in Appendix 2 are of greater concern for delayed-onset hearing loss. Early and more frequent assessment may be indicated for children with CMV infection, 118,125,126 syndromes associated with progressive hearing loss, 72 neurodegenerative disorders, 72 trauma, [127][128][129] or culturepositive postnatal infections associated with sensorineural hearing loss 130,131 ; for children who have received ECMO 64 or chemotherapy 132 ; and when there is caregiver concern or a family history of hearing loss. 16 For all infants with and without risk indicators for hearing loss, developmental milestones, hearing skills, and parent concerns about hearing, speech, and language skills should be monitored during routine medical care consistent with the AAP periodicity schedule.…”

Section: Communication Assessment and Interventionmentioning

confidence: 99%