Late-onset, progressive sensorineural hearing loss after severe neonatal respiratory failure.
OBJECTIVE
To determine the prevalence of sensorineural hearing loss (SNHL) at the age of 4 years among survivors of severe neonatal respiratory failure with and without congenital diaphragmatic hernia and to document the occurrence of late-onset or progressive SNHL among the survivors.


METHODS
Prospective, longitudinal secondary outcome study.


METHODS
Multicenter Canadian study in 9 tertiary referral centers.


METHODS
Eighty-one (89%) of ninety 4-year-old survivors born from 1994 to 1996 of > or =34 weeks gestation at birth with severe neonatal respiratory failure (2 oxygenation indices > or =25 at least 15 minutes apart).


METHODS
Repeated audiologic measurements from birth to the age of 4 years with documentation of the entire cohort at 2 and 4 years of age.


RESULTS
Forty-three (53%) of 81 tested 4-year-old survivors had SNHL; 28 (42%) of 66 without congenital diaphragmatic hernia and 15 (100%) of 15 with congenital diaphragmatic hernia. High-frequency SNHL occurred in 65% of the patients. Of the 43 children with SNHL at 4 years, 30 (70%) had loss at 2 years, and 18 (60%) of these 30 had progressive loss between 2 and 4 years of age. For 13 children with SNHL onset after 2 years of age, the loss was less severe with lesser involvement of the lower frequencies.


CONCLUSIONS
Survivors of severe neonatal respiratory failure frequently develop late-onset SNHL that may be progressive. Urgent investigation is required to enable further understanding and prevention of this problem. Severe neonatal respiratory failure should be an indication for long-term audiologic surveillance.
Robertson
Charlene M T
CM
Neonatal and Infant Follow-up Clinic, Glenrose Rehabilitation Hospital, Capital Health Authority, 10230 111th Avenue, Edmonton, Alberta T5G 0B7, Canada. croberts@cha.ab.ca
Tyebkhan
Juzer M
JM
Hagler
Marian E
ME
Cheung
Po-Yin
PY
Peliowski
Abraham
A
Etches
Philip C
PC
D017668:Age of Onset; D002675:Child, Preschool; D018450:Disease Progression; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000453:epidemiology* / Q000209:etiology* / Q000503:physiopathology; D006548:Hernia, Diaphragmatic / Q000150:complications; D065630:Hernias, Diaphragmatic, Congenital; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases; D008137:Longitudinal Studies; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D012131:Respiratory Insufficiency / Q000150:complications*; D012720:Severity of Illness Index