印度中部三级保健中心高危新生儿听力损失的危险因素:一项前瞻性观察研究

Leena Dhande, Prerana Ganaboor, Rasika Hattewar, Chetan Jaiswal
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引用次数: 0

摘要

听力障碍和耳聋是影响世界5%人口的全球性问题,近3400万儿童需要康复来解决听力损失问题。在新生儿重症监护病房(NICUs)中,听力危险因素的发生率大约高出10-20倍,这意味着新生儿重症监护病房中2-5%的新生儿可能受到影响。HL的早期诊断和干预可以从及时配戴助听器或人工耳蜗中获益。目的:本研究的目的是评估印度中部一家三级医院新生儿重症监护病房和特殊新生儿护理病房(sncu)发生HL的危险因素。材料和方法:这项前瞻性、观察性、单中心研究于2019年10月至2021年9月在印度马哈拉施特拉邦那格浦尔英迪拉·甘地政府医学院和医院儿科进行。本研究共纳入319名从nicu和sncu出院的HL高危新生儿。研究了早产、低出生体重(LBW)、弓形虫病、风疹、巨细胞病毒、单纯疱疹(TORCH)感染、新生儿窒息、新生儿败血症、脑膜炎、换血、辅助通气和HL等危险因素之间的关系。采用卡方检验评估SNHL与危险因素的相关性。结果:感音神经性听力损失(SNHL)发生率为3.76%。新生儿窒息(p值<0.01)、换血(p值<0.001)、TORCH感染(p值<0.001)、脑膜炎(p值<0.001)和辅助通气(p值<0.001)被发现是SNHL相关的重要危险因素。结论:根据危险因素的评估,新生儿应在出生后1个月内进行听力筛查,并在3个月大时做出诊断。这使得专家可以在六个月大的时候开始治疗和干预,帮助听力受损的儿童避免语义剥夺的有害后果。
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Risk Factors for Hearing Loss in High-Risk Neonates at a Tertiary Care Centre in Central India: A Prospective Observational Study
Introduction: Hearing impairment and deafness are global issues that affect 5% of the world’s population, with nearly 34 million children requiring rehabilitation to address their hearing loss (HL). An approximately 10-20 fold higher incidence of audiological risk factors has been noted in Neonatal Intensive Care Units (NICUs), which translates that 2-5% of all newborns in NICUs may be affected. Early diagnosis of HL and intervention can be advantageous from the timely fitting of hearing aids or cochlear implants. Aim: The aim of this study was to evaluate the risk factors for HL in NICUs and Special Neonatal Care Units (SNCUs) at a tertiary care hospital in Central India. Materials and Methods: This prospective, observational, single-centre study was conducted from October 2019 to September 2021 in the Department of Paediatrics at Indira Gandhi Government Medical College and Hospital, Nagpur, Maharashtra, India. A total of 319 neonates at high risk for HL, discharged from NICUs and SNCUs, were included in the study. The association between risk factors like prematurity, low birth weight (LBW), Toxoplasmosis, Rubella, Cytomegalovirus, Herpes Simplex (TORCH) infections, neonatal asphyxia, neonatal sepsis, meningitis, exchange transfusion, assisted ventilation, and HL were studied. The chi-square test was used to assess the association between SNHL and risk factors. Results: The incidence of Sensorineural Hearing Loss (SNHL) was 3.76%. Neonatal asphyxia (p-value <0.01), exchange transfusion (p-value <0.001), TORCH infections (p-value < 0.001), meningitis (p-value <0.001), and assisted ventilation (p-value <0.001) were found to be significant risk factors associated with SNHL. Conclusion: Based on the assessment of risk factors, it was concluded that neonates should undergo hearing screening tests within the first month of life, and a diagnosis should be made by three months of age. This allows specialists to initiate treatment and intervention by six months of age, helping children with impaired hearing avoid the harmful consequences of semantic deprivation.
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