1785例新生儿听力检查结果分析

摘要

Objective To analyze the association between elective cesarean section ( ECS ) and newborn hearing by studying the newborn hearing examination results. Methods Newborns and their parents visiting ENT department and pediatric department of Xi' an Children' s Hospital between March 2006 and September 2009 were enrolled by two cohort study. These infants were divided into ECS cases ( ECS group, 889 infants with 1778 ears ) and spontaneous delivery cases ( spontaneous delivery group, 896 infants with 1792 ears ) according to self-designed questionnaire survey and their illness records. The infants underwent otoacoustic emission (OAE) hearing screening first, and then those who failed in OAE screening received another examination called distortion product otoacoustic emission ( DPOAE ) at 42 day after birth. The study was conducted with informed consent of parents and approved by Xi'an Children's Hospital Ethics Committee. Results 1785 infants ( 3570 ears ) were all screened by OAE, and the results showed that hearing of ECS group was significantly lower than that of spontaneous delivery group, and the difference was significant ( χ2= 26. 64, P < 0. 005 ). 145 infants needed DPOAE examination at 42 day after birth, but only 136 infants ( 272 ears ) participated. The results of second DPOAE examination showed that the hearing pass rate of ECS group was significantly lower than that of spontaneous delivery group, and the difference was significant (χ2 = 10. 80,P<0.005 ). Conclusion Two groups of infants are all screened by OAE, and the hearing pass rate of newborns spontaneously delivered is higher than that of ECS cases. The difference is significant. The hearing pass rate of spontaneous delivery newborns is still higher in DPOAE examination, and the difference is statistically significant. Therefore, caution on ECS should be taken and the possible harm caused by the risk factor should be reconsidered.%目的 研究新生儿听力检查结果,分析社会因素剖宫产和新生儿听力之间的关系.方法 收集自2006年3月至2009年9月资料,以西安市儿童医院新生儿科和耳鼻喉科就诊的新生儿及父母为研究对象,采用双向队列研究方法,通过问卷调查和查阅病历界定社会因素剖宫产婴儿队列(剖宫产组)和自然分娩婴儿队列(顺产组).剖宫产组889例(1 778耳)和顺产组896例(1 792耳),共1 785例(3 570耳),均先行耳声发射听力筛查,对未通过OAE听力筛查的新生儿在出生42天进行畸变产物耳声发射听力检查.所有研究家长知情同意并经过院伦理委员会批准.结果 1 785例(3 570耳)婴儿耳声发射测试,结果显示剖宫产组婴儿听力通过率明显低于顺产组,差异有显著性(χ2=26.64,P＜0.05).其中需复筛145例,实际复筛136例(272耳),第2次畸变产物耳声发射检查结果:剖宫产组婴儿听力通过率明显低于顺产组,且差异有显著性(χ2=10.80,P＜0.05).结论 两组婴儿听力通过率有显著性差异.提示要对社会因素剖宫产提高警惕,重视这个危险因素可能造成的危害.