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Hearing and Neurological Impairment in Children with History of Exchange Transfusion for Neonatal Hyperbilirubinemia

机译:新生儿高胆红素血症换血病史患儿的听力和神经功能障碍

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摘要

The objective was to determine frequency of sensorineural hearing loss (SNHL), identified by abnormal threshold in evoked potentials, absence of otoacoustic emissions and behavioral responses, auditory neuropathy (AN) (absence of evoked potentials, with preservation of otoacoustic emissions), and neurological comorbidity in infants with hyperbilirubinemia (HB) treated with exchange-transfusion (ET). From a total of 7,219 infants, ET was performed on 336 (4.6%). Inclusion criteria were fulfilled in 102; 234 children did not meet criteria (182 outside of the study period, 34 did not have complete audiological evaluation, and 18 rejected the followup). Thirty-five children (34%) were born at-term and 67 (66%) were preterm. Children had a mean age of 5.5 ± 3.9 years. Main causes of ET were Rh isoimmunization in 48 (47%), ABO incompatibility in 28 (27.5%), and multifactorial causes in 26 (25.5%). Fifteen (15%) children presented with SNHL. Preterm newborns presented more often with SNHL. Indirect bilirubin level was higher in children with SNHL (22.2 versus 18.7 mg/dL, P = 0.02). No cases of AN were documented. An increased risk of neurologic sequelae was observed in children with SNHL. In conclusion, we disclosed a high frequency of SNHL in children with neonatal HB and ET and neurological alterations. No cases of AN were observed.
机译:目的是确定感觉神经性听力损失(SNHL)的频率,该频率由诱发电位的异常阈值,不存在耳声发射和行为反应,听觉神经病(AN)(不存在诱发电位,并保持耳声发射)和神经系统疾病确定交换输血(ET)治疗的高胆红素血症(HB)婴儿合并症。在总共7,219名婴儿中,对336名(4.6%)进行了ET。 102个国家符合纳入标准; 234名儿童不符合标准(在研究期以外有182名儿童,有34名儿童没有完整的听力学评估,还有18名拒绝随访)。三十五名儿童(34%)足月出生,而67名(66%)早产。儿童的平均年龄为5.5±3.9岁。 ET的主要病因是Rh同种免疫48例(47%),ABO不相容28例(27.5%)和多因素26例(25.5%)。十五名(15%)儿童出现SNHL。早产儿出现SNHL的频率更高。 SNHL患儿的间接胆红素水平较高(22.2 vs 18.7mg / dL,P = 0.02)。没有记录AN病例。 SNHL患儿出现神经系统后遗症的风险增加。总之,我们发现新生儿HB和ET并伴有神经系统改变的儿童出现SNHL的频率很高。没有观察到AN病例。

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