沈阳地区新生儿听力筛查未通过的高危因素分析

Analysis of high risk factors for failure of newborn in hearing screening in Shenyang area

目的探讨新生儿听力筛查未通过的高危因素。方法对我院2014年1月至2018年7月1262例新生儿采用双耳畸变产物耳声发射和自动听性脑干反应进行听力筛查,采用回顾性方法分析所有新生儿及其生母电子病历系统资料包括:新生儿胎龄、新生儿性别、分娩方式、产妇年龄、新生儿胆红素脑病、新生儿窒息、高胆红素血症和分娩时胎膜早破等进行单因素及多因素Logistic回归分析,探讨影响其听力受损的危险因素。结果1262例(2524耳)新生儿听力初筛未通过64例(5.07%),其中双耳未通过例36例(56.25%),单独左耳未通过15例(23.44%),单独右耳未通过13例(20.31%)。单因素和进一步Logistics回归分析显示,胎龄<32周、新生儿胆红素脑病、新生儿窒息、高胆红素血症和分娩时胎膜早破是新生儿听力筛查未通过的独立危险因素(P<0.01)。结论胎龄<32周、新生儿胆红素脑病、新生儿窒息、新生儿高胆红素血症和产妇分娩时胎膜早破是新生儿听力损失的高危因素,采取听力筛查措施早期发现并给予相应干预,减少新生儿听力损失的发生率。

Objective To investigate the risk factors for the failure of newborn in hearing screening.Methods A total of 1 262 neonates were tested for hearing by otoacoustic emissions(OAE) and automatic auditory brainstem response(AABR) from January 2014 to July 2018 in our hospital. All the data of the newborn and their mothers were analyzed retrospectively. The electronic medical record includes: neonatal gestational age, neonatal gender, mode of delivery, maternal age, neonatal bilirubin encephalopathy, neonatal asphyxia, hyperbilirubinemia, and premature rupture of membranes. Univariate and multivariate logistic regression analysis was used to explore the risk factors affecting hearing loss.Results In the 1 262 cases, 64 cases(5.07%) failed in the hearing screening, of which 36 cases(56.25%) failed in both ears, 15 cases(23.44%) failed in the left ear and 13(20.31%) in the right ear. Univariate and further Logistics regression analysis showed that gestational age <32 W, neonatal bilirubin encephalopathy, neonatal asphyxia, hyperbilirubinemia, and premature rupture of membranes were independent risk factors for neonatal in failure hearing screening(P<0.01).Conclusion Gestational age <32 W, neonatal bilirubin encephalopathy, neonatal asphyxia, hyperbilirubinemia and premature rupture of membranes are risk factors for neonatal hearing loss. Hearing screening measures should be adopted to make early detection and intervention in order to reduce the incidence of hearing loss in the newborn.