title: Antenatal factors modulate hearing screen failure risk in preterm infants.
abstract: OBJECTIVE
  The objective of this study was to characterise the effects of antenatal inflammatory factors and maternal therapies on neonatal hearing screen outcomes in very low birthweight infants.
  
  
  METHODS
  We conducted a retrospective study of a cohort of infants <33 weeks' gestational age and <1501 g birth weight prospectively enrolled between 1999 and 2003 for whom placental pathology, cord blood interleukin (IL) 6, IL-1ß, tumour necrosis factor-α and neonatal hearing screen results were available.
  
  
  RESULTS
  Of 289 infants with documented hearing screen results, 244 (84%) passed and 45 (16%) failed the hearing screen (unilateral, N=25 (56%); bilateral, N=20 (44%)). In the final logistic model, the fetal inflammatory response syndrome defined as the presence of fetal vasculitis and/or cord serum IL-6>18.2 pg/mL was the factor with greatest risk for hearing screen failure (OR 3.62, 95% CI 1.38 to 9.5). A patent ductus arteriosus treated with indomethacin significantly increased the risk (OR 3.3, 95% CI 1.3 to 8.26), while combined maternal steroid and magnesium sulfate exposure (0.37, 95% CI 0.11 to 0.81) reduced the risk for hearing screen failure.
  
  
  CONCLUSIONS
  Intrauterine infection with a fetal inflammatory response is a risk factor for neonatal hearing loss while maternal therapies significantly reduced the risk of neonatal hearing loss in very low birthweight infants.
authors.affiliation: Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA.
authors.forename: Jocelyn C
authors.initials: JC
authors.lastname: Leung
authors.affiliation: Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA.
authors.forename: Christina L
authors.initials: CL
authors.lastname: Cifra
authors.affiliation: Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA.
authors.forename: Alexander G
authors.initials: AG
authors.lastname: Agthe
authors.affiliation: Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland, USA.
authors.forename: Chen-Chih J
authors.initials: CC
authors.lastname: Sun
authors.affiliation: Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA.
authors.forename: Rose M
authors.initials: RM
authors.lastname: Viscardi
mesh_terms: D016207:Cytokines / Q000097:blood; D005260:Female; D034381:Hearing Loss / Q000209:etiology*; D006320:Hearing Tests; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000209:etiology*; D019102:Infant, Very Low Birth Weight; D008297:Male; D015997:Neonatal Screening / Q000379:methods; D011247:Pregnancy; D011248:Pregnancy Complications; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D016207:Cytokines
keywords: antenatal steroids; fetal inflammatory response syndrome; hearing loss; magnesium sulfate; prematurity