ON THE QUESTION OF HEARING IMPAIRMENT IN PREMATURE CHILDREN WHO HAVE EXPERIENCED OXIDATIVE STRESS AT BIRTH
Introduction. Hearing impairment (HI) occupies an important place among perinatal pathology. According to the WHO, the frequency of severe hearing impairment is observed in 1–2 per 1000 newborns and in 15% of newborns who required intensive therapy after birth. Mild and moderate HI occurs in 1–2% o...
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Bukovynian State Medical University
2023-05-01
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| Series: | Неонатологія, хірургія та перинатальна медицина |
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| Online Access: | http://neonatology.bsmu.edu.ua/article/view/285215 |
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| author | Т. Клименко Т. Знаменська О. Карапетян О. Мельничук |
| author_facet | Т. Клименко Т. Знаменська О. Карапетян О. Мельничук |
| author_sort | Т. Клименко |
| collection | DOAJ |
| description |
Introduction. Hearing impairment (HI) occupies an important place among perinatal pathology. According to the
WHO, the frequency of severe hearing impairment is observed in 1–2 per 1000 newborns and in 15% of newborns who
required intensive therapy after birth. Mild and moderate HI occurs in 1–2% of children with perinatal pathology.
The aim of the work is to study the predictors of hearing impairment and the factors that determine the severity
of deafness in children aged 2–3 months who suffered oxidative stress at birth.
Material and methods. 131 cases of observation of newborns of 27–36 weeks of gestation with HI in Communal
nonprofit enterprise «City perinatal center» Kharkiv city council were analyzed. Children whose families had cases
of HI were excluded from the study. During the observation, the audiological examination was carried out in the
newborn period (primary examination) and at 2–3 months of age. To meet the aim of the work, alternative groups
were formed: Group I (n=51) with unilateral and Group II (n=80) with bilateral hearing impairment.
To determine the predictors of the severity of PS in the comparison groups, the factors determining deafness
were studied, and their prognostic informativeness was established. The t-Student and φ-Fisher criteria were
determined, the Wald-Henkin heterogeneous sequential procedure algorithm was used, predictive coefficients (PC)
and informativeness (I) were determined.
By decision of the Bioethics Commission № 3 dated March 21, 2023, the study materials comply with the Tokyo
Declaration of the World Medical Association, the International Recommendations of the Helsinki Declaration on
Human Rights, the Council of Europe Convention on Human Rights and Biomedicine, the Laws of Ukraine, and the
requirements of the Code of Ethics of a Doctor of Ukraine.
The study was carried out within the framework of the scientific research work of the Department of Pediatrics
№ 3 and Neonatology of KhNMU «Study of peculiarities of the course of oxidant stress diseases in newborns» 2022–
2024 (state registration № А22U000025).
Results. Factors of obstetric and somatic anamnesis of the mother did not influence the nature of HI in the child.
Among the complications of pregnancy and childbirth in the anamnesis of children with bilateral HI, dysfunction of
placenta was more often observed 33.8 and 13.7 % (р<0.001), threat of abortion 30.0 and 17.6 % (<0.05), anemia
pregnant women 31.2 and 13.7 % (p<0.001), fetal distress 56.2 and 37.3 % (p<0.01), cesarean delivery 68.8 and 47.1
% (p <0.001), especially regarding fetal distress – 67.3 and 29.2 % (р<0.001).
The frequency of bilateral HI in children is inversely proportional to gestational age and birth weight and is
associated with a low Apgar score. Sexual dimorphism was revealed: girls predominated in the group with bilateral
hearing loss, 56.2 and 35.3 % (р<0.001). Children with bilateral HI more often required surfactant therapy 78.8 and
33.3 % (p<0.001), as well as longer respiratory support and oxygen therapy.
In the study, bilateral HI was more common in children with diseases whose pathogenesis is closely related
to oxidative stress: periventricular leukomalacia 55.0 and 7.8 % (<0.001); bronchopulmonary dysplasia (BPD)
of the 2nd and 3rd degree: 23.7 and 2.0 % (p<0.001) and 23.7 and 0 % (p<0.001), respectively; retinopathy of
prematurity grade 2–3 42.5 and 17.6 % (р<0.001); with an PDA 81.3 and 41.2 % (p<0.001), including when surgical
closure was necessary, 18.5 and 9.5 % (p<0,05). The highest informativeness of hearing impairment in children
who have undergone oxidative stress belongs to the following characteristics: gestational age (6.14), total duration
of mechanical ventilation (5.54), body weight (5.44), BPD (5.4), duration of mechanical ventilation in mode of
normoventilation (4.1), duration of oxygen therapy (3.91), PDA (3.72).
The most significant prognostic factors of bilateral hearing impairment: the presence of BPD 2–3 stages. (-13.8);
intraventricular hemorrhage (IVH) 2–3 st. (-12.4); total duration of ventilator ≥21 days (-10.33); gestation period
≤29 weeks (-8.6); periventricular leukomalacia (PVL) 2–3 st. (-8.48); duration of oxygen therapy ≥21 days (-7.38);
body weight (-6.94).
Conclusions: The most significant prognostic factors of bilateral hearing impairment: the presence of BPD 2–3
st. (-13.8); IVH 2–3 st. (-12.4); total duration of ventilator ≥21 days (-10.33); gestation period ≤29 weeks (-8.6);
periventricular leukomalacia 2–3 st. (-8.48); duration of oxygen therapy ≥21 days (-7.38); body weight (-6.94), etc.
Bilateral hearing impairment is predicted in newborns based on the presence of gestational immaturity (gestational
term ≤ 29 weeks), BPD grade 2–3, IVH grade 2–3, total duration of mechanical ventilation and oxygen therapy > 21
days, PVL grade 2–3. In our study, no reliable relationship was found between the nature of the hearing impairment of a
prematurely born child and the somatic and obstetric anamnesis of the mother. Gender characteristics among premature
infants with bilateral HI were characterized by the predominance of the female gender, 56.2 and 35.3 % (р<0.001).
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| first_indexed | 2024-03-12T16:58:31Z |
| format | Article |
| id | doaj.art-2dd4d0e135444c4ba07923803a095f08 |
| institution | Directory Open Access Journal |
| issn | 2226-1230 2413-4260 |
| language | English |
| last_indexed | 2024-03-12T16:58:31Z |
| publishDate | 2023-05-01 |
| publisher | Bukovynian State Medical University |
| record_format | Article |
| series | Неонатологія, хірургія та перинатальна медицина |
| spelling | doaj.art-2dd4d0e135444c4ba07923803a095f082023-08-07T18:50:04ZengBukovynian State Medical UniversityНеонатологія, хірургія та перинатальна медицина2226-12302413-42602023-05-01132(48)10.24061/2413-4260.XIІI.2.48.2023.3ON THE QUESTION OF HEARING IMPAIRMENT IN PREMATURE CHILDREN WHO HAVE EXPERIENCED OXIDATIVE STRESS AT BIRTHТ. Клименко0Т. Знаменська1О. Карапетян2О. Мельничук3Kharkiv national medical universitySI «Institute of Pediatrics, Obstetrics and Gynecology named after academician O.M. Lukyanova of the NAMS of Ukraine»Kharkiv national medical universityCommunal nonprofit enterprise «City perinatal center» Kharkiv city council Introduction. Hearing impairment (HI) occupies an important place among perinatal pathology. According to the WHO, the frequency of severe hearing impairment is observed in 1–2 per 1000 newborns and in 15% of newborns who required intensive therapy after birth. Mild and moderate HI occurs in 1–2% of children with perinatal pathology. The aim of the work is to study the predictors of hearing impairment and the factors that determine the severity of deafness in children aged 2–3 months who suffered oxidative stress at birth. Material and methods. 131 cases of observation of newborns of 27–36 weeks of gestation with HI in Communal nonprofit enterprise «City perinatal center» Kharkiv city council were analyzed. Children whose families had cases of HI were excluded from the study. During the observation, the audiological examination was carried out in the newborn period (primary examination) and at 2–3 months of age. To meet the aim of the work, alternative groups were formed: Group I (n=51) with unilateral and Group II (n=80) with bilateral hearing impairment. To determine the predictors of the severity of PS in the comparison groups, the factors determining deafness were studied, and their prognostic informativeness was established. The t-Student and φ-Fisher criteria were determined, the Wald-Henkin heterogeneous sequential procedure algorithm was used, predictive coefficients (PC) and informativeness (I) were determined. By decision of the Bioethics Commission № 3 dated March 21, 2023, the study materials comply with the Tokyo Declaration of the World Medical Association, the International Recommendations of the Helsinki Declaration on Human Rights, the Council of Europe Convention on Human Rights and Biomedicine, the Laws of Ukraine, and the requirements of the Code of Ethics of a Doctor of Ukraine. The study was carried out within the framework of the scientific research work of the Department of Pediatrics № 3 and Neonatology of KhNMU «Study of peculiarities of the course of oxidant stress diseases in newborns» 2022– 2024 (state registration № А22U000025). Results. Factors of obstetric and somatic anamnesis of the mother did not influence the nature of HI in the child. Among the complications of pregnancy and childbirth in the anamnesis of children with bilateral HI, dysfunction of placenta was more often observed 33.8 and 13.7 % (р<0.001), threat of abortion 30.0 and 17.6 % (<0.05), anemia pregnant women 31.2 and 13.7 % (p<0.001), fetal distress 56.2 and 37.3 % (p<0.01), cesarean delivery 68.8 and 47.1 % (p <0.001), especially regarding fetal distress – 67.3 and 29.2 % (р<0.001). The frequency of bilateral HI in children is inversely proportional to gestational age and birth weight and is associated with a low Apgar score. Sexual dimorphism was revealed: girls predominated in the group with bilateral hearing loss, 56.2 and 35.3 % (р<0.001). Children with bilateral HI more often required surfactant therapy 78.8 and 33.3 % (p<0.001), as well as longer respiratory support and oxygen therapy. In the study, bilateral HI was more common in children with diseases whose pathogenesis is closely related to oxidative stress: periventricular leukomalacia 55.0 and 7.8 % (<0.001); bronchopulmonary dysplasia (BPD) of the 2nd and 3rd degree: 23.7 and 2.0 % (p<0.001) and 23.7 and 0 % (p<0.001), respectively; retinopathy of prematurity grade 2–3 42.5 and 17.6 % (р<0.001); with an PDA 81.3 and 41.2 % (p<0.001), including when surgical closure was necessary, 18.5 and 9.5 % (p<0,05). The highest informativeness of hearing impairment in children who have undergone oxidative stress belongs to the following characteristics: gestational age (6.14), total duration of mechanical ventilation (5.54), body weight (5.44), BPD (5.4), duration of mechanical ventilation in mode of normoventilation (4.1), duration of oxygen therapy (3.91), PDA (3.72). The most significant prognostic factors of bilateral hearing impairment: the presence of BPD 2–3 stages. (-13.8); intraventricular hemorrhage (IVH) 2–3 st. (-12.4); total duration of ventilator ≥21 days (-10.33); gestation period ≤29 weeks (-8.6); periventricular leukomalacia (PVL) 2–3 st. (-8.48); duration of oxygen therapy ≥21 days (-7.38); body weight (-6.94). Conclusions: The most significant prognostic factors of bilateral hearing impairment: the presence of BPD 2–3 st. (-13.8); IVH 2–3 st. (-12.4); total duration of ventilator ≥21 days (-10.33); gestation period ≤29 weeks (-8.6); periventricular leukomalacia 2–3 st. (-8.48); duration of oxygen therapy ≥21 days (-7.38); body weight (-6.94), etc. Bilateral hearing impairment is predicted in newborns based on the presence of gestational immaturity (gestational term ≤ 29 weeks), BPD grade 2–3, IVH grade 2–3, total duration of mechanical ventilation and oxygen therapy > 21 days, PVL grade 2–3. In our study, no reliable relationship was found between the nature of the hearing impairment of a prematurely born child and the somatic and obstetric anamnesis of the mother. Gender characteristics among premature infants with bilateral HI were characterized by the predominance of the female gender, 56.2 and 35.3 % (р<0.001). http://neonatology.bsmu.edu.ua/article/view/285215Preterm Infants; Hearing Impairment; Oxidative Stress |
| spellingShingle | Т. Клименко Т. Знаменська О. Карапетян О. Мельничук ON THE QUESTION OF HEARING IMPAIRMENT IN PREMATURE CHILDREN WHO HAVE EXPERIENCED OXIDATIVE STRESS AT BIRTH Неонатологія, хірургія та перинатальна медицина Preterm Infants; Hearing Impairment; Oxidative Stress |
| title | ON THE QUESTION OF HEARING IMPAIRMENT IN PREMATURE CHILDREN WHO HAVE EXPERIENCED OXIDATIVE STRESS AT BIRTH |
| title_full | ON THE QUESTION OF HEARING IMPAIRMENT IN PREMATURE CHILDREN WHO HAVE EXPERIENCED OXIDATIVE STRESS AT BIRTH |
| title_fullStr | ON THE QUESTION OF HEARING IMPAIRMENT IN PREMATURE CHILDREN WHO HAVE EXPERIENCED OXIDATIVE STRESS AT BIRTH |
| title_full_unstemmed | ON THE QUESTION OF HEARING IMPAIRMENT IN PREMATURE CHILDREN WHO HAVE EXPERIENCED OXIDATIVE STRESS AT BIRTH |
| title_short | ON THE QUESTION OF HEARING IMPAIRMENT IN PREMATURE CHILDREN WHO HAVE EXPERIENCED OXIDATIVE STRESS AT BIRTH |
| title_sort | on the question of hearing impairment in premature children who have experienced oxidative stress at birth |
| topic | Preterm Infants; Hearing Impairment; Oxidative Stress |
| url | http://neonatology.bsmu.edu.ua/article/view/285215 |
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