Risk Factors for Sensorineural Hearing Loss and Auditory Maturation in Children Admitted to Neonatal Intensive Care Units: Who Recovered?

Abstract

Background: Newborns admitted to neonatal intensive care units (NICUs) are at higher risk of developing sensorineural hearing loss (SNHL), which may improve over time. The aim of this study was to describe the prevalence of the main risk factors for SNHL in a NICU cohort, focusing on children who underwent auditory maturation. Methods: An observational study of 378 children admitted to NICUs, who were followed for at least 18 months, with periodic audiologic assessments. Results: Out of 378 patients, 338 had normal hearing and 40 were hearing-impaired; we found a higher percentage of extremely preterm (EPT) and extremely low-birthweight (ELBW) infants in SNHL children (p < 0.05). Seventeen infants presented auditory improvement, with a mean maturation time of 6.17 months. A significant difference emerged between patients with stable SNHL and those who improved only in the case of hyperbilirubinemia (p = 0.005). The initial hearing threshold was a predictor of auditory improvement and moderately correlated to the time of auditory maturation (p = 0.02). Conclusions: Our study supports the trend toward recognizing worse prognoses and slower maturation processes among NICU children who suffer from severe to profound SNHL. Caution must be taken when deciding on earlier cochlear implantation.

Hearing Loss and Risk Factors in Very Low Birth Weight Infants

“…As already stated in our previous paper [33] and in contrast with proposals of other authors [3,23,26], we believe that 3 months of CA is an adequate age to achieve an ABR diagnosis, above all in extremely preterm infants. This behavior could allow to differentiate among changes in threshold due to the normal maturation of the auditory pathways, temporary HL and permanent SNHL needing treatment.…”

“…These findings are not in agreement with those of Wroblewska-Seniuk [3], who did not find a significant correlation between exposure to ototoxic medications and HL in a nation-wide premature newborns study. Similarly, Salvago et al [26] did not find a relation between HL and ototoxic drugs in a study involving a heterogeneous population of preterm and at-term infants in which all ototoxic drugs are considered together and without specifying the overall duration of therapy.…”

Risk Factors Associated With Hearing Impairment in Infants and Children: A Systematic Review

“…As a result, it emphasizes how crucial a good environment is for promoting a child's development of motor skills [ 19 ]. Salvago et al recommended a prudent cochlear implantation in newborns and noted that NICU children with sensorineural hearing loss (SNHL) reported worse prognoses and delayed maturation rates [ 12 ].…”

“…The findings of the review revealed a wide variety of maternal and neonatal factors that have an impact on HL in children. Studies that were included in this review were conducted in a number of different countries, which include India [ 10 , 26 ], Egypt [ 11 ], Korea [ 14 , 15 ], Iran [ 16 , 17 ], Gaza [ 13 ], Jordan [ 23 ], Nigeria [ 20 ], Poland [ 21 ], Sweden [ 18 ], Thailand [ 22 ], Italy [ 12 ], Brazil [ 19 ], and Turkey [ 24 , 25 ]. Overall, the majority of these studies have appraised the role of a variety of maternal and neonatal factors related to HL.…”

“…OAE was used in four studies [ 21 , 22 , 24 , 25 ], five studies [ 11 , 12 , 16 - 18 ] used TEOAE, and three studies utilized distortion product otoacoustic emission (DPOAE) [ 10 , 23 , 25 ]. On the other hand, Salvago et al [ 12 ] used behavioral observation audiometry or visual reinforcement audiometry, and Hardani et al employed auditory steady-state responses [ 17 ]. Araujo et al used the affordances in the home environment for the motor development-infant scale (AHEMD-IS), a simplistic, useful, and self-administered questionnaire that is suitable for children between the ages of three and eighteen months [ 19 ].…”