2023年—2024年邯郸市新生儿听力筛查结果及听力损失的影响因素分析

Analysis of neonatal hearing screening results and the risk factors for hearing impairment in Handan city (2023-2024)

摘要:

目的 分析2023年—2024年邯郸市新生儿听力筛查结果及听力损失的影响因素。方法 回顾性分析2023年1月—2024年12月在邯郸市妇幼保健院出生的10 886例活产新生儿及产妇的临床资料。所有新生儿均采取畸变产物耳声发射法检测听力损失，根据新生儿听力筛查通过情况分为听力正常组和听力损失组。比较听力正常组和听力损失组产妇、新生儿的临床资料，采用多因素一般Logistic回归分析新生儿听力损失的影响因素。结果 10 886例新生儿中听力筛查的初筛率为98.95%（10 772/10 886），初筛未通过1 205例（11.19%），复筛1 039例（86.22%），复筛阳性32例，阳性转诊32例，其中14例确诊。听力损失组产妇原发性巨细胞病毒感染率和围生期宫内感染率均高于听力正常组（P <0.05）；听力损失组新生儿重度高胆红素血症占比及新生儿巨细胞病毒感染占比高于听力正常组（P <0.05）。多因素一般Logistic回归分析结果显示，产妇原发性巨细胞病毒感染［O^R =3.766（95% CI：1.119，12.673）］、围生期宫内感染［O^R =3.651（95% CI：1.085，12.286）］、新生儿重度高胆红素血症［O^R =3.762（95 %CI：1.118，12.659）］和新生儿巨细胞病毒感染［O^R =4.059（95% CI：1.206，13.659）］均为新生儿听力损失的危险因素（P <0.05）。结论 2023年—2024年邯郸市新生儿中听力损失的发生率较低，产妇原发性巨细胞病毒感染、围生期宫内感染、新生儿重度高胆红素血症及新生儿巨细胞病毒感染与新生儿听力损失的发生有关。

Abstract:

Objective To explore the results of neonatal hearing screening in Handan City from 2023 to 2024 and analyze the risk factors for hearing impairment.Methods A total of 10 886 live-born neonates delivered at Handan Maternal and Child Health Hospital from January 2023 to December 2024 were included in the study. All participants underwent hearing screening using the Distortion Product Otoacoustic Emission (DPOAE) test. Based on the results, the neonates were divided into two groups: the normal hearing group and the hearing impairment group. The influencing factors of neonatal hearing impairment were analyzed.Results The initial screening rate of hearing screening among 10 886 newborns was 98.95% (10 772 cases /10 886 cases).1 205 cases failed the initial screening, and the failure rate of the initial screening was 11.19% (1 205 cases /10 772 cases). There were 1 039 cases of re-screening, and the rate of re-screening was 86.22%. There were 32 cases of positive re-screening and 32 cases of positive referral. And 14 cases were diagnosed. Among the 14 neonates who failed the screening, 6 were male and 8 were female. The types of hearing impairment were as follows: 2 cases of conductive hearing loss and 12 cases of sensorineural hearing loss. The affected ear distribution was 3 cases in the right ear and 11 cases in the left ear. The comparison of maternal primary CMV infection rate and perinatal intrauterine infection rate between hearing impaired group and normal hearing group showed statistical significance (P < 0.05). The maternal primary CMV infection rate and perinatal intrauterine infection rate in hearing impaired group were higher than those in normal hearing group. The ratio of neonatal severe hyperbilirubinemia and neonatal CMV infection rate between hearing impaired group and normal hearing group were compared, and the difference was statistically significant (P < 0.05). The proportion of neonatal severe hyperbilirubinemia and neonatal CMV infection in hearing impaired group was higher than that in normal hearing group. Multivariate general Logistic regression analysis showed that: maternal primary CMV infection [O^R = 3.766 (95% CI: 1.119, 12.673) ], perinatal intrauterine infection [O^R = 3.651 (95% CI: 1.085, 12.286) ], severe hyperbilirubinemia in neonates [O^R = 3.762 (95% CI: 1.118, 12.659)], and neonatal CMV infection [O^R = 4.059 (95% CI: 1.206, 13.659) ] were significant risk factors for neonatal hearing impairment (P < 0.05).Conclusion The incidence of neonatal hearing impairment in Handan City in 2023-2024 is relatively low. Maternal primary CMV infection, neonatal severe hyperbilirubinemia, neonatal CMV infection, and perinatal intrauterine infection are associated with the occurrence of neonatal hearing impairment.