不能通过新生儿听力筛查的危险因素分析

摘要

Objective To explore the risk factors of failed hearing screening in newborns. Methods The clinical data of 719 in rants who admitted in Children's Hospital of Chongqing Medical University from January 2009 to July and underwent hearing screening,were analyzed retrospectively by univariatechi square test and multivariate Logistic regression analysis, to identify the risk factors of failed hearing screening in newborns. Results 160 newborns (22.3％) failed hearing screening. Hyperbilirubinemia above the threshold of exchange transfusion,bilirubin encephalopathy,positive serous CiV[V antibody,small for gestational age in fant,NBNA score ≤35 ,hemolytic jaundice,early onset jaundice(appear within first 24 hours of life) ,craniofacial anomalies might be the risk factors of failed hearing screening in newborns(P＜0. O5)by one way analysis. Multivariate Logistic regression analysis indicated that hyperbilirubinemia above the threshold of exchange transfusion,positive serous CMV antibody,NBNA score ≤ 35,craniofacial anomalies were risk factors of failed hearing screening(OR were 2. 861,1. 488,1. 623, 5. 913; 95 ％CI were 1. 067 7. 669,1. 037 2.135 ,1. 123 2. 347,1.852 18.87,respectively). Conclusion Hyperbilirubinemia above the threshold of exchange transfusion,positive serous CMV antibody,NBNA score≤35 and craniofacial anomalies are the risk factors of failed hearing screening in newborns.%目的 探讨新生儿听力筛查未通过的危险因素.方法 收集重庆医科大学附属儿童医院新生儿病房2009年1～7月719例住院患儿的听力筛查及临床相关资料.采用单因素χ2检验和多因素Logistic回归分析,筛选出不能通过新生儿听力筛查的危险因素.结果 160例(22.3%)新生儿未通过听力筛查.单因素分析显示达到换血标准的高胆红素血症、胆红素脑病、血清巨细胞病毒(CMV)抗体阳性、小于胎龄儿、NBNA≤35分、溶血性黄疸、黄疸发病不超过1 d、颅面部畸形可能与新生儿听力筛查未通过有关(P<0.05).多因素Logistic回归分析表明,达到换血标准的高胆红素血症、血清CMV抗体阳性、NBNA≤35分、颅面部畸形是新生儿听力筛查未通过的危险因素(OR值分别为2.861、1.488、1.623、5.913;95%CI分别为1.067～7.669、1.037～2.135、1.123～2.347、1.852～18.870).结论 达到换血标准的高胆红素血症、血清CMV抗体阳性、NBNA≤35分、颅面部畸形是不能通过新生儿听力筛查的危险因素.