Hearing outcomes in preterm infants with confirmed hearing loss
Hearing outcomes in preterm infants with confirmed hearing loss
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DOI：
10.1016/j.ijporl.2022.111262
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发表时间：
2022-08-07
影响因子：
1.5
通讯作者：
Cantarella, Giovanna
中科院分区：
文献类型：
--
作者：
Alde, Mirko;Di Berardino, Federica;Cantarella, Giovanna
目的：早产儿听力损失（HL）的风险很高。本研究的目的是评估受 HL 影响的早产儿在数月内经历听力改善的频率，并评估与听力变化相关的可能因素。方法：这项回顾性研究是在三级转诊听力中心进行的。使用2012年1月1日至2020年6月30日期间点击诱发的听觉脑干反应，对出生后前3个月内确诊为感音神经性HL的早产儿在18个月校正年龄时进行重新评估。评估听力改善的频率以及可能的危险因素与听力变化之间的关联。结果：总共评估了 138 名早产儿（71 名男性和 67 名女性；平均胎龄：30+2 周）。听力改善和听力阈值正常化的百分比分别为58.7%（81/138）和35.5%（49/138）。我们观察到，与接受纯婴儿配方奶粉的早产儿相比，接受纯母乳喂养或混合喂养的早产儿听力改善的频率更高（80% vs 29.3%，P < 0.001）。结论：这项研究证实了对有早产史的儿童进行长期听力学随访和推迟人工耳蜗植入指征的重要性。由于间充质干细胞的表达和较高的总抗氧化能力，母乳可能对早产儿的听觉系统起到保护作用。这些发现可能对临床实践产生重要影响，对早产儿的长期听力结果产生积极影响。
Objectives: Premature infants are at high risk for hearing loss (HL). The aim of the present study is to assess the frequency of preterm infants affected by HL who experience hearing improvement over months and evaluate possible factors associated with hearing changes. Methods: This retrospective study was conducted in a third-level referral audiologic center. Preterm infants with a confirmed diagnosis of sensorineural HL within the first 3 months of life were reassessed at 18 months corrected age using the click-evoked auditory brainstem response between January 1, 2012, and June 30, 2020. The frequency of hearing improvement and associations between possible risk factors and hearing changes were evaluated. Results: A total of 138 preterm infants (71 male and 67 female; mean gestational age: 30+2 weeks) were assessed. The percentages of hearing improvement and hearing threshold normalization were 58.7% (81/138) and 35.5% (49/138), respectively. We observed a higher frequency of hearing improvement among preterm infants who had received exclusive breastfeeding or mixed feeding compared with those who had received exclusive infant for-mula (80% versus 29.3%, P < 0.001). Conclusion: This study confirms the importance of performing a long audiological follow-up and postponing the indication for cochlear implantation in children with a history of preterm birth. Because of the expression of mesenchymal stem cells and high total antioxidant capacity, breast milk might play a protective role in the auditory system of preterm infants. These findings could have important implications for clinical practice, positively impacting the long-term hearing outcomes of preterm infants.