Hearing impairment after asphyxia and neonatal encephalopathy: a Norwegian population-based study.
Eur J Pediatr
; 183(3): 1163-1172, 2024 Mar.
Article
in En
| MEDLINE
| ID: mdl-37991501
ABSTRACT
The purpose of this study is to evaluate the association between perinatal asphyxia, neonatal encephalopathy, and childhood hearing impairment. This is a population-based study including all Norwegian infants born ≥ 36 weeks gestation between 1999 and 2014 and alive at 2 years (n = 866,232). Data was linked from five national health registries with follow-up through 2019. Perinatal asphyxia was defined as need for neonatal intensive care unit (NICU) admission and an Apgar 5-min score of 4-6 (moderate) or 0-3 (severe). We coined infants with seizures and an Apgar 5-min score < 7 as neonatal encephalopathy with seizures. Infants who received therapeutic hypothermia were considered to have moderate-severe hypoxic-ischemic encephalopathy (HIE). The reference group for comparisons were non-admitted infants with Apgar 5-min score ≥ 7. We used logistic regression models and present data as adjusted odds ratios (aORs) with 95% confidence intervals (CI). The aOR for hearing impairment was increased in all infants admitted to NICU moderate asphyxia aOR 2.2 (95% CI 1.7-2.9), severe asphyxia aOR 5.2 (95% CI 3.6-7.5), neonatal encephalopathy with seizures aOR 7.0 (95% CI 2.6-19.0), and moderate-severe HIE aOR 10.7 (95% CI 5.3-22.0). However, non-admitted infants with Apgar 5-min scores < 7 did not have increased OR of hearing impairment. The aOR for hearing impairment for individual Apgar 5-min scores in NICU infants increased with decreasing Apgar scores and was 13.6 (95% CI 5.9-31.3) when the score was 0. Conclusions:
An Apgar 5-min score < 7 in combination with NICU admission is an independent risk factor for hearing impairment. Children with moderate-severe HIE had the highest risk for hearing impairment. What is Known ⢠Perinatal asphyxia and neonatal encephalopathy are associated with an increased risk of hearing impairment. ⢠The strength of the association, and how other co-morbidities affect the risk of hearing impairment, is poorly defined. What is New ⢠Among neonates admitted to a neonatal intensive care unit (NICU), decreased Apgar 5-min scores, and increased severity of neonatal encephalopathy, were associated with a gradual rise in risk of hearing impairment. ⢠Neonates with an Apgar 5-min score 7, but without NICU admission, did not have an increased risk of hearing impairment.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Asphyxia Neonatorum
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Hypoxia-Ischemia, Brain
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Hearing Loss
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Infant, Newborn, Diseases
Limits:
Child
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Female
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Humans
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Infant
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Newborn
/
Pregnancy
Language:
En
Journal:
Eur J Pediatr
Year:
2024
Document type:
Article
Affiliation country:
Norway