Risk patterns associated with transient hearing impairment and permanent hearing loss in infants born very preterm: A retrospective study

• Published in: Developmental medicine and child neurology Vol. 65; no. 4; pp. 479 - 488
• Main Authors: Yu, Wen‐Hao, Lin, Yung‐Chieh, Chu, Chi‐Hsiang, Chen, Ray‐Bing, Wu, Jiunn‐Liang, Huang, Chao‐Ching
• Format: Journal Article
• Language: English
• Published: England 01.04.2023
• Subjects: Deafness; Female; Hearing Loss - diagnosis; Hemorrhage; Humans; Infant; Infant, Extremely Premature; Infant, Newborn; Male; Retrospective Studies
• ISSN: 0012-1622; 1469-8749
• DOI: 10.1111/dmcn.15440

Aim To determine the risk patterns associated with transient hearing impairment (THI) and permanent hearing loss (PHL) of infants born very preterm who failed hearing screenings. Method We enrolled 646 infants (347 males, 299 females) born at no more than 30 weeks' gestation between 2006 and 2020 who received auditory brainstem response screening at term‐equivalent age. Audiological examinations of infants who failed the screening revealed THI, when hearing normalized, or PHL, defined as a persistent unilateral or bilateral hearing threshold above 20 dB. Principal component analysis (PCA) was used to characterize risk patterns. Results Among the 646 infants, 584 (90.4%) had normal hearing, 42 (6.5%) had THI, and 20 (3.1%) had PHL. Compared with the group with normal hearing, the THI and PHL groups had significantly higher rates of neurodevelopmental impairment at 24 months corrected age. PCA of risk patterns showed the THI group and especially the PHL group had more severe haemodynamic and respiratory instability. Moreover, severe intraventricular haemorrhage (IVH) was also a risk for PHL. Propensity score matching revealed an association of haemodynamic and respiratory instability with PHL. Interpretation In infants born preterm, the severity and duration of haemodynamic and respiratory instability are risk patterns for both THI and PHL; severe IVH is an additional risk for PHL. What this paper adds Neurodevelopmental delay was more common in infants born preterm who failed hearing screening. Principal component analysis revealed the risk patterns associated with hearing impairment. Haemodynamic–respiratory instability was associated with transient and permanent hearing impairment outcomes. Severe haemodynamic–respiratory instability and intraventricular haemorrhage was associated with permanent hearing loss. Video Podcast: https://youtu.be/kPptSdBoKiU What this paper adds Neurodevelopmental delay was more common in infants born preterm who failed hearing screening. Principal component analysis revealed the risk patterns associated with hearing impairment. Haemodynamic–respiratory instability was associated with transient and permanent hearing impairment outcomes. Severe haemodynamic–respiratory instability and intraventricular haemorrhage was associated with permanent hearing loss.