Hearing screening in at-risk neonate cohort.
OBJECTIVE
This prospective study reports on the prevalence of hearing impairment in an at-risk neonatal intensive care unit (NICU) population.


METHODS
From 1990 to 1997, 942 neonates were screened with transient evoked otoacoustic emissions (TEOAE) and brainstem evoked response audiometry (BERA).


RESULTS
835 Infants passed the primary screen for both ears, 57 for one ear, adding up to 94.7%. Seventeen infants (1.9%) were lost to follow-up. In thirteen infants (1.4%), bilateral hearing impairment above 30 dB was confirmed. While all children with hearing impairment belonged to the group of 820 children receiving aminoglycosides, only one presented no other risk factors. In 11 of the hearing impaired children other anamnestic factors, i.e. dysmorphism, prenatal rubella or cytomegaly, family history of hearing loss or severe peri- and postnatal complications seem to be more probable causes of the identified hearing loss.


CONCLUSIONS
From our data, aminoglycosides seem not to be an important risk factor for communication related hearing impairment, when serum levels are continuously monitored, as occurred in our cohort. After adjustment for other risk factors, birth weight between 1000 and 1500 g and a gestational age between 29 and 31 weeks were no predictive markers for hearing impairment. It might be speculated that the improved medical treatment in a Neonatal Intensive Care Unit (NICU) reduces the probability of hearing impairment for those two groups. Conductive hearing loss as a possible additional cause for hearing impairment was not studied in detail, but the high percentage of malformations detected (four out of 13 hearing impaired infants) demands further monitoring, close follow-up, counselling and adequate treatment.
Hess
M
M
Department of Audiology and Phoniatrics, Benjamin Franklin Medical Center, Freie Universität Berlin, Germany. hessmark@zedat.fu-berlin.de
Finckh-Krämer
U
U
Bartsch
M
M
Kewitz
G
G
Versmold
H
H
Gross
M
M
D000161:Acoustic Stimulation; D000617:Aminoglycosides; D000900:Anti-Bacterial Agents / Q000009:adverse effects; D001300:Audiometry, Evoked Response; D015331:Cohort Studies; D019465:Craniofacial Abnormalities / Q000453:epidemiology; D005260:Female; D006311:Hearing Disorders / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D008297:Male; D015997:Neonatal Screening; D011446:Prospective Studies; D012307:Risk Factors
D000617:Aminoglycosides; D000900:Anti-Bacterial Agents