Risk Factors of Sensorineural Hearing Loss in Preterm Infants

Borradori, Cristina; Fawer, C. L.; Buclin, Thierry; Calame, A

doi:10.1159/000244391

Cited by 83 publications

(72 citation statements)

References 26 publications

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“…(Tabela 1) A incidência de meningite na literatura varia de 6 a 22%. 1 [16][17][18][19] Diante desses dados, observa-se que algumas das principais causas de perda auditiva na infância como rubéola, meningite e ototoxicidade, são passíveis de prevenção. Utilizando-se medidas simples como programas de vacinação, orientação pré-natal adequada, maior informação de profissionais de saúde quanto à prescrição de medicações ototóxicas, pode-se realizar a profilaxia da deficiência auditiva.…”

Section: Resultsunclassified

Análise das principais etiologias de deficiência auditiva em Escola Especial "Anne Sullivan"

Cecatto

Garcia

Costa

et al. 2003

Rev. Bras. Otorrinolaringol.

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Obj etivo: Determinar as principais etiologias de deficiência auditiva em estudantes da Escola de Ensino Especial para surdos "Anne Sullivan" em São Caetano do Sul e comparar com os dados da literatura mundial. Forma de estudo: Estudo retrospectivo Material e método: Cento e trinta e um alunos da escola no ano de 2001 foram avaliados através de análise de seus prontuários, levando-se em conta dados de anamnese com a família, exame físico otorrinolaringológi-co, avaliação fonoaudiológica e psicológica. Resultados: Dos 131 pacientes, 67 (51%) eram do sexo masculino e 64 (49%) do sexo feminino. A perda auditiva sensorioneural foi a mais encontrada, representando 99% dos casos. Quanto ao grau de disacusia, 65% foi classificado como profundo. Quanto à etiologia, 24% foi classificada como desconhecida e das causas identificáveis a rubéola congênita foi a mais encontrada (22%). Na maioria dos pacientes a suspeita e o diagnóstico foram feitos com 12 meses de idade. Conclusões: A etiologia não definida foi a mais representativa, seguida pela rubéola, e a idade de diagnóstico predominou entre 12 e 30 meses. Aim:The purpose of this study was to determine the etiology of hearing loss in students of "Escola de Ensino Especial Anne Sullivan" at São Caetano do Sul to make a comparison of the results with the literature. Study design: Retrospective study. Material and method: We analyzed the medical history of 131 students in 2001, including the familiar anamnesis, otorhinolaryngological, psychological and audiological examination. Results: In the group, 67 (51%) were males and 64 (49%) females; 99% showed sensorineural hearing loss, 65% classified as profound. Etiological factors: in 24% no cause of hearing impairment could be determined; rubella was found in 22% of the children. The majority of the children had the suspicion and the diagnosis within 12 months old. Conclusions: The undefined etiology was the main finding, followed by congenital rubella. The diagnosis has to be made between 12 and 30 months. Rev Bras Otorrinolaringol. V.69, n.2, 235-40, mar./abr. 2003 ORIGINAL ARTICLE ARTIGO ORIGINAL «« ««Palavras-chave: perda auditiva, surdez, infância, etiologia.

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Section: Resultsunclassified

Análise das principais etiologias de deficiência auditiva em Escola Especial "Anne Sullivan"

Cecatto

Garcia

Costa

et al. 2003

Rev. Bras. Otorrinolaringol.

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“…38 The use of aminoglycosides to treat infants with sepsis may also have contributed to deafness. [55][56][57] The association between jaundice and deafness is considered to be due to bilirubin deposition in the brainstem. [58][59][60][61] Sepsis, a risk factor for the development of toxic effects of bilirubin, may have contributed to these effects.…”

Section: Commentmentioning

confidence: 99%

Neurodevelopment and Predictors of Outcomes of Children With Birth Weights of Less Than 1000 g

Hack

Wilson-Costello

Friedman

et al. 2000

Arch Pediatr Adolesc Med

328

215

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Objective: To examine the neurosensory and cognitive status of extremely low-birth-weight (ELBW; Ͻ1000 g) children born from January 1, 1992, through December 31, 1995, and to identify the significant predictors of outcome.Design: An inception cohort of ELBW infants admitted to the neonatal intensive care unit (NICU) and observed to 20 months' corrected age.Setting: A tertiary level urban NICU and follow-up clinic at a university hospital.Population: Of 333 ELBW infants without major congenital malformations admitted to the NICU, 241 (72%) survived to 20 months' corrected age. We studied 221 children (92%) at a mean of 20 months' corrected age. The mean birth weight was 813 g; mean gestational age, 26.4 weeks.Main Outcome Measures: Assessments of cognitive and neurosensory development.Results: Major neurosensory abnormality was present in 54 children (24%), including 33 (15%) with cerebral palsy, 20 (9%) with deafness, and 2 (1%) with blindness. The mean (± SD) Bayley Mental Developmental Index (MDI) score was 74.7 ± 17. Ninety-two children (42%) had a subnormal MDI score (Ͻ70). Neurodevelopmental impairment (neurosensory abnormality and/or MDI score Ͻ70) was present in 105 children (48%). Multiple stepwise logistic regression analysis that considered sex, social risk, birth weight, and neonatal risk factors revealed significant predictors of a subnormal MDI score to be male sex (odds ratio [OR], 2.73; 95% confidence interval [CI], 1.52-4.92), social risk (OR, 1.48; 95% CI, 1.09-2.00), and chronic lung disease (OR, 2.18; 95% CI, 1.20-3.94). Predictors of neurologic abnormality were a severely abnormal finding on cerebral ultrasound (OR, 8.09; 95% CI,) and chronic lung disease (OR, 2.46; 95% CI, 1.12-5.40); predictors of deafness were male sex (OR, 2.79; 95% CI, 1.02-7.62), sepsis (OR, 3.15; 95% CI, 1.05-9.48), and jaundice (maximal bilirubin level, Ͼ171 µmol/L [Ͼ10 mg/dL]) (OR, 4.80; 95% CI, 1.46-15.73). Conclusion:There is an urgent need for research into the etiology and prevention of neonatal morbidity. Med. 2000;154:725-731 Arch Pediatr Adolesc

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“…Ototoxicity relates to the average concentration that contributes to the saturation of cochlear cell binding sites (4); the antibiotic penetration of the middle ear with inflammation is increased, and this increased permeability may also contribute to hearing loss after meningitis (20). Epidemiologic studies in cohorts of neonates in whom aminoglycosides were administered for a variety of infectious diseases could not document an independent impact of this drug when an extended time interval approach was used (4,6,10,17). In contrast, meningitis is a well-known risk factor for ototoxicity (6,11).…”

Section: Discussionmentioning

confidence: 99%

“…Epidemiologic studies in cohorts of neonates in whom aminoglycosides were administered for a variety of infectious diseases could not document an independent impact of this drug when an extended time interval approach was used (4,6,10,17). In contrast, meningitis is a well-known risk factor for ototoxicity (6,11).…”

Section: Discussionmentioning

confidence: 99%

Cerebrospinal Fluid Compartmental Pharmacokinetics of Amikacin in Neonates

Allegaert

Scheers²,

Adams³

et al. 2008

Antimicrob Agents Chemother

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The incidence of early-onset bacterial infection in the neonate varies from 0.5 to 1% of the total number of deliveries but is significantly higher in preterm neonates, where infection is causally linked with premature delivery in ca. 50% of cases (14). Late-onset, nosocomial bacterial infections occur in a significant number of preterm and term neonates during their stay in the neonatal intensive care unit. Bacteremia, pneumonia, necrotizing enterocolitis, and meningitis are the most frequent loci for infection in neonates. Empirical treatment for suspected infection in early neonatal life consists of combination therapy based on a time-dependent (beta-lactamase) and a concentration-dependent (aminoglycoside) antibiotic coverage (e.g., Streptococcus agalactiae and Escherichia coli), whereas in late neonatal life coagulase-negative Staphylococcus should also be covered.The bactericidal effectiveness of amikacin is linked to intermittent, discontinuous peak concentrations, whereas renal side effects and ototoxicity relate to the average serum concentration that contributes to the saturation of renal and cochlear cell binding sites. The combination of bactericidal effect and toxicity data has resulted in the concept of administration of relative larger doses with extended dosing intervals between consecutive doses. The safety and effectiveness of extended interval dosing of aminoglycosides in neonates has been reviewed (19). After the first few days of postnatal life, size, postmenstrual age (PMA), renal function, and ventilation contribute to renal drug clearance variability in neonates and subsequent serum concentration (1, 2, 3).The effectiveness of amikacin for treating meningitis depends on the concentrations in the central nervous system, and this compartment is separated from the blood by the bloodbrain barrier (BBB). Access of aminoglycosides to the central nervous compartment is limited in healthy children and adults (8,26,28), but cerebrospinal fluid (CSF) aminoglycoside exposure after systemic administration is more extended in children with meningitis than in those without meningitis (24). Correlations between antibiotic concentration and CSF glucose content, CSF leukocytosis, or CSF protein concentrations have been investigated (12,13,15,26,27). Ototoxicity relates to the mean aminoglycoside concentration in the central nervous system compartment, but a genetic predisposition to develop aminoglycoside-related ototoxicity has also been documented (4,10,17,23).Observations on maturational amikacin CSF disposition in neonates are therefore of relevance (17,19). However, data on amikacin CSF concentrations are limited in neonates, and amikacin CSF time-concentration profiles in preterm neonates have not been reported (9). In the present study, time-concentration profiles of amikacin in serum and single CSF samples were collected to evaluate the relationship between serum and CSF concentration and to explore the impact of CSF inflammatory markers (leuko-, gluco-, and protidorhachia) on this relationship du...

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Risk Factors of Sensorineural Hearing Loss in Preterm Infants

Cited by 83 publications

References 26 publications

Análise das principais etiologias de deficiência auditiva em Escola Especial "Anne Sullivan"

Análise das principais etiologias de deficiência auditiva em Escola Especial "Anne Sullivan"

Neurodevelopment and Predictors of Outcomes of Children With Birth Weights of Less Than 1000 g

Cerebrospinal Fluid Compartmental Pharmacokinetics of Amikacin in Neonates

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